Individual
LIDDIA GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
419 E MAGNOLIA AVE, SAN ANTONIO, TX 78212-3012
(210) 785-3855
(210) 587-3533
Mailing address
PO BOX 15440, SAN ANTONIO, TX 78212-8640
(210) 785-3039
(210) 587-3533
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11667
TX
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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