Provider Demographics
NPI:1336851989
Name:STRODER, TWYLA LASONE (LMBT)
Entity type:Individual
Prefix:
First Name:TWYLA
Middle Name:LASONE
Last Name:STRODER
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4806 BEECHCROFT DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-4012
Mailing Address - Country:US
Mailing Address - Phone:336-253-3424
Mailing Address - Fax:
Practice Address - Street 1:4806 BEECHCROFT DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-4012
Practice Address - Country:US
Practice Address - Phone:336-253-3424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18286225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist