Thaedeus Holston
NPI #1386220697 in Brandon, Mississippi
Provider Information
- NPI Number
- 1386220697
- Entity Type
- Individual
- Name
- Thaedeus Holston
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Mar 18, 2021
- Last Updated
- Mar 18, 2021
Practice Location
- Address
- 613 MARQUETTE RD
- City
- Brandon
- State
- Mississippi
- ZIP Code
- 39042-3038
- Phone
- (601) 824-0342
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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