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General NPI Number Information
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NPI Number | 1720883341
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Entity Type | Organization
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Legal Business Name | TACTICAL TRAUMA THERAPY PLLC
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 112 SPARROW HAWK TRL
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City | BOERNE
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State | TX
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Zip | 78006-8951
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Country | US
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Telephone | 210-984-3703
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Fax |
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Provider Business Mailing Address
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Address Line | 112 SPARROW HAWK TRL
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City | BOERNE
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State | TX
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Zip | 78006-8951
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Country | US
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Telephone | 210-984-3703
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR / PSYCHOTHERAPIST
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Name | MR. RYAN CURTISS
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Credential | LCSW
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Telephone | 210-984-3703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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