Individual
JESSICA WALLINGSFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
3014 RIVAS ST, SAN ANTONIO, TX 78228-6222
(210) 268-5211
Mailing address
249 LAKE RDG, HELOTES, TX 78023-2286
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14754
TX
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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