Provider Demographics
NPI:1134910862
Name:THROWER, JALEN (CSSP)
Entity type:Individual
Prefix:
First Name:JALEN
Middle Name:
Last Name:THROWER
Suffix:
Gender:M
Credentials:CSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 E PLEASANT RUN RD STE 131
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4211
Mailing Address - Country:US
Mailing Address - Phone:682-564-1815
Mailing Address - Fax:
Practice Address - Street 1:1229 E PLEASANT RUN RD STE 131
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4211
Practice Address - Country:US
Practice Address - Phone:682-564-1815
Practice Address - Fax:214-613-2163
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator