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Individual

MS. TIFFANY PELTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCDC

Contact information

Practice address
12304 LOS INDIOS TRL # A, AUSTIN, TX 78729-7625
(832) 318-4971
Mailing address
12304 LOS INDIOS TRL # A, AUSTIN, TX 78729-7625

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13719
TX

Other

Enumeration date
10/05/2021
Last updated
10/05/2021
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