Individual
TIFFANY LEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
402 CARLETON CT, SAN ANTONIO, TX 78212-3014
(210) 785-3031
Mailing address
402 CARLETON CT, SAN ANTONIO, TX 78212-3014
(210) 785-3031
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17171
TX
Other
Enumeration date
04/14/2026
Last updated
04/14/2026
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