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General NPI Number Information
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NPI Number | 1902032980
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Entity Type | Individual
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Provider Name | BEDYNILVA TRUJILLO PH.D.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2009
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Last Update Date | 06/07/2010
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Provider Practice Location Address
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Address Line | CALLE ANDRES ARUZ RIVERA # 200 E LOCAL B - 3
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City | GURABO
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State | PR
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Zip | 00778-0660
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Country | US
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Telephone | 787-737-7979
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 11388
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City | CAROLINA
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State | PR
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Zip | 00987-9638
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3171
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License Number State | PR
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