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NPI Code Detail

MEDICARE: MRS. TIFFANY MARIE CENTERS MA

MEDICARE: MRS. TIFFANY MARIE CENTERS MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YP2500XProfessional Counselor74138TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427134378
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TIFFANY MARIE CENTERS MA
Provider Business Mailing Address
First Line : 6800 PARK TEN BLVD STE 200S
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78213-4293
Country : US
Telephone Number : 210-261-1042
Fax Number : 210-261-1821
Provider Business Practice Location Address
First Line : 6800 PARK TEN BLVD STE 200S
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78213-4293
Country : US
Telephone Number : 210-261-1042
Fax Number : 210-261-1821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2006
Last Update Date : 05/03/2022

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Directions to “ MRS. TIFFANY MARIE CENTERS MA” Practice Location

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