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General NPI Number Information
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NPI Number | 1407220130
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Entity Type | Individual
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Provider Name | JESSICA MARIE HERNANDEZ-BENAVIDEZ LPC
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Gender | Female
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Dates
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Enumeration Date | 11/18/2015
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Last Update Date | 03/11/2019
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Provider Practice Location Address
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Address Line | 2939 W. WOODLAWN BUIDLING 2
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City | SAN ANTONIO
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State | TX
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Zip | 78228
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Country | US
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Telephone | 210-503-4463
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Fax |
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Provider Business Mailing Address
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Address Line | 2939 W WOODLAWN AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78228-5015
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Country | US
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Telephone | 210-846-6173
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 71480
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License Number State | TX
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