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General NPI Number Information
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NPI Number | 1023749066
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Entity Type | Individual
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Provider Name | TRAJA GOLSTON CSW
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Gender | Female
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Dates
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Enumeration Date | 06/21/2022
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Last Update Date | 06/27/2024
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Provider Practice Location Address
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Address Line | 525 ALEXANDER ST
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City | JONESBORO
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State | LA
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Zip | 71251-2001
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Country | US
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Telephone | 318-259-4676
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Fax | 318-259-4677
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Provider Business Mailing Address
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Address Line | 1000 CHINABERRY DR STE 900
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City | BOSSIER CITY
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State | LA
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Zip | 71111-2455
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Country | US
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Telephone | 318-990-1052
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 17394
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License Number State | LA
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