Organization
ERECOVERED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY MILLER LCDC (VICE PRESIDENT)
(210) 602-6439
Entity
Organization
Contact information
Practice address
6206 STABLE DOWNS, SAN ANTONIO, TX 78249-4604
(210) 602-6439
Mailing address
6206 STABLE DOWNS, SAN ANTONIO, TX 78249-4604
(210) 602-6439
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13499
TX
Other
Enumeration date
04/14/2018
Last updated
04/14/2018
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