| Doctor Name: | DR. CLYDE FRANKLIN TRUAN |
| NPI Number: | 1104093632 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 000921 |
| Business Practice Address: | 2465 Demere Rd Suite 209 St Simons Island, GA - 315221630 |
| Business Phone Number: | 9123995414 |
| Business Fax Number: | 9122677981 |
| Mailing Address: | 2465 Demere Rd, Suite 209 ST SIMONS ISLAND |
| State: | GA |
| Postal Code: | 315221630 |
| Phone Number: | 9123995414 |
| Fax Number: | 9122677981 |
| NPI Enumeration Date: | 05/14/2008 |
| NPI Last Update Date: | 05/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 000921 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |