Basic Information
| Provider Information | |||||||||
| NPI: | 1164882858 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRUJILLO | ||||||||
| FirstName: | MARTA | ||||||||
| MiddleName: | CLAUDIA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 E MCMILLAN ST | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452061922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136194843 | ||||||||
| FaxNumber: | 5134755673 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 E MCMILLAN ST | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452061922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136194843 | ||||||||
| FaxNumber: | 5134755673 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2016 | ||||||||
| LastUpdateDate: | 02/24/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | E.0700149-SUPV | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.