Provider Demographics
NPI:1013238211
Name:CORTINAS, TIFFANY SPELLER
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:SPELLER
Last Name:CORTINAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:SHAWN
Other - Last Name:SPELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8546 PARK OLYMPIA
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-3255
Mailing Address - Country:US
Mailing Address - Phone:210-391-6466
Mailing Address - Fax:
Practice Address - Street 1:570 PINN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-1234
Practice Address - Country:US
Practice Address - Phone:210-397-0530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35238104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker