Provider Demographics
NPI:1962608299
Name:WALKER, TIFFANY ANNE (MS, LPC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANNE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8315 SLIPPERY ROCK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-2355
Mailing Address - Country:US
Mailing Address - Phone:210-373-4687
Mailing Address - Fax:
Practice Address - Street 1:1400 RIDGE CREEK LN
Practice Address - Street 2:
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78163-2804
Practice Address - Country:US
Practice Address - Phone:210-373-4687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-24
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19375101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional