Healthcare Provider Details

I. General information

NPI: 1992624944
Provider Name (Legal Business Name): EMILY TRUJILLO CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13611 ROBEY RD
SILVER SPRING MD
20904-4829
US

IV. Provider business mailing address

1401 GLEASON ST
SILVER SPRING MD
20902-3723
US

V. Phone/Fax

Practice location:
  • Phone: 240-740-1420
  • Fax:
Mailing address:
  • Phone: 240-472-1969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12052
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: