Individual
JAN BUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 HARPER DR, MARSHALL, TX 75672-5712
(512) 497-6541
Mailing address
670 SPUR 156, WASKOM, TX 75692-9129
(903) 687-2586
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13341
TX
Other
Enumeration date
07/03/2018
Last updated
07/03/2018
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