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General NPI Number Information
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NPI Number | 1023994167
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Entity Type | Individual
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Provider Name | JASMINE A CANTU
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Gender | Female
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 3601 SWISS AVE
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City | DALLAS
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State | TX
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Zip | 75204-6225
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Country | US
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Telephone | 469-862-8301
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Fax |
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Provider Business Mailing Address
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Address Line | 4632 JUNIUS ST
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City | DALLAS
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State | TX
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Zip | 75246-1090
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 95109
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 618814
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License Number State |
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