Provider Demographics
NPI:1942766753
Name:TRAUGHBER, EDDIE (LMFT-S)
Entity Type:Individual
Prefix:
First Name:EDDIE
Middle Name:
Last Name:TRAUGHBER
Suffix:
Gender:M
Credentials:LMFT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 BELT LINE RD STE 213
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-3201
Mailing Address - Country:US
Mailing Address - Phone:469-955-5373
Mailing Address - Fax:
Practice Address - Street 1:1111 BELT LINE RD STE 213
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-3201
Practice Address - Country:US
Practice Address - Phone:469-955-5373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-17
Last Update Date:2019-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4749106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist