Provider Demographics
NPI:1043094808
Name:TROSCLAIR, JADE GLADYS
Entity Type:Individual
Prefix:
First Name:JADE
Middle Name:GLADYS
Last Name:TROSCLAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 WHISPERING HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-4660
Mailing Address - Country:US
Mailing Address - Phone:281-900-4866
Mailing Address - Fax:
Practice Address - Street 1:731 N WALNUT AVE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-7927
Practice Address - Country:US
Practice Address - Phone:830-507-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst