JONATHAN LANE RUST

MANOR, TX
NPI1801419080
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: TX  15033)
Enumeration Date2020-05-22
Last Update Date2020-05-22
Business Address
JONATHAN LANE RUST LCDC
11503 PARSONS RD
MANOR, TX 78653-5220
Phone number: 512-278-4550
Mailing Address
JONATHAN LANE RUST LCDC
11503 PARSONS RD
MANOR, TX 78653-5220
Phone number: