Individual provider · Type 1 NPI

Thaedeus Holston

Mental Health Counselor · Brandon, MS

NPI number 1386220697 Active

Practice location

613 Marquette Rd
Brandon, MS 39042-3038

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1386220697

Thaedeus Holston's National Provider Identifier is 1386220697, issued on Mar 18, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Brandon, MS. The record was last updated on Mar 18, 2021.