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General NPI Number Information
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NPI Number | 1295557882
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Entity Type | Individual
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Provider Name | JESSICA BOWEN NUNEZ MA, LPA-IP
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Gender | Female
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 26010 OAK RIDGE DR STE 107
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City | THE WOODLANDS
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State | TX
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Zip | 77380-1972
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Country | US
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Telephone | 281-815-0899
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Fax | 281-528-1107
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Provider Business Mailing Address
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Address Line | 14311 WILDWOOD SPRINGS LN
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City | HOUSTON
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State | TX
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Zip | 77044-5471
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Country | US
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Telephone | 571-225-9352
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 38411
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License Number State | TX
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