Individual
JONATHAN LANE RUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC
Contact information
Practice address
11503 PARSONS RD, MANOR, TX 78653-5220
(512) 278-4550
Mailing address
11503 PARSONS RD, MANOR, TX 78653-5220
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15033
TX
Other
Enumeration date
05/22/2020
Last updated
05/22/2020
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