Provider Demographics
NPI:1972716454
Name:TRUJILLO, NILSA (MED)
Entity type:Individual
Prefix:MRS
First Name:NILSA
Middle Name:
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 221
Mailing Address - Street 2:RIDGEWOOD DRIVE
Mailing Address - City:RUSSELL
Mailing Address - State:MA
Mailing Address - Zip Code:01071-0221
Mailing Address - Country:US
Mailing Address - Phone:413-977-1773
Mailing Address - Fax:413-734-1561
Practice Address - Street 1:2155 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3301
Practice Address - Country:US
Practice Address - Phone:413-736-0395
Practice Address - Fax:413-734-1651
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health