Maddix, Tiesha

Maddix, Tiesha is an sole proprietor health care provider with primary practice located at 3551 Roger Brooke Dr , Fort Sam Houston TX 78234-4504. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Maddix, Tiesha can be contacted via phone (210) 539-6102.

Contact Information

Primary practice address
3551 Roger Brooke Dr Fort Sam Houston TX 78234-4504
Phone: (210) 539-6102
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 592 Wyoming
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Clinical 103TC0700X 596 Wyoming

Profile Details

NPI number 1841659323
LBN Legal business name Maddix, Tiesha
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 12th, 2016
Last updated Mar 22nd, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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