Individual
EMILY J JACQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5121 CRESTWAY RD STE 200B, WINDCREST, TX 78239-1975
(210) 849-6188
Mailing address
5121 CRESTWAY RD STE 200B, WINDCREST, TX 78239-1975
(800) 805-6989
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
41324
TX
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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