Individual
JESSICA RISINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSAA
Contact information
Practice address
557 VANCOUVER RD SE APT B, RIO RANCHO, NM 87124-3855
(505) 301-2735
Mailing address
557 VANCOUVER RD SE APT B, RIO RANCHO, NM 87124-3855
(505) 301-2735
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0156941
NM
Other
Enumeration date
02/08/2016
Last updated
02/08/2016
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