Individual
JESSICA LEDESMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10831 W KALER DR, GLENDALE, AZ 85307-1723
(623) 385-6167
Mailing address
10831 W KALER DR, GLENDALE, AZ 85307-1723
(623) 385-6167
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
INTERN
AZ
101YM0800X
Mental Health Counselor
Primary
INTERN
AZ
101YP2500X
Professional Counselor
INTERN
AZ
Other
Enumeration date
04/13/2021
Last updated
04/13/2021
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