Individual
TYRONE RAUL TENNESSEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCDC-I
Contact information
Practice address
519 E QUINCY ST, SAN ANTONIO, TX 78215-1632
(210) 299-1614
Mailing address
519 E QUINCY ST, SAN ANTONIO, TX 78215-1632
(210) 299-1614
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
TX
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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