Provider Demographics
NPI:1548925878
Name:TOMLINSON, LORA (LCDC)
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:
Last Name:TOMLINSON
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21258 WATERCOURSE WAY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78266-2568
Mailing Address - Country:US
Mailing Address - Phone:254-749-9770
Mailing Address - Fax:
Practice Address - Street 1:3050 EISENHAUER RD APT 501
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-3564
Practice Address - Country:US
Practice Address - Phone:254-749-9770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14761101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)