Individual
MRS. JESSICA MARIE STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
2800 BEAUMONT AVE, STE. D-1, LIBERTY, TX 77575-5126
(936) 776-2979
(281) 377-5870
Mailing address
2800 BEAUMONT AVE, STE D-1, LIBERTY, TX 77575-5126
(936) 776-2979
(281) 377-5870
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11991
TX
Other
Enumeration date
04/17/2013
Last updated
04/17/2013
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