Individual provider · Type 1 NPI

Trysten Fugate, BS

Mental Health Counselor · Mattoon, IL

NPI number 1093386393 Active

Practice location

750 Broadway Ave E
Mattoon, IL 61938-4610

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1093386393

Trysten Fugate, BS's National Provider Identifier is 1093386393, issued on Jul 7, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Mattoon, IL. The record was last updated on Jul 7, 2021.