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General NPI Number Information
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NPI Number | 1518569425
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Entity Type | Individual
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Provider Name | JANA WESSON MARTIN LPC
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Gender | Female
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Dates
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Enumeration Date | 11/15/2020
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Last Update Date | 11/15/2020
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Provider Practice Location Address
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Address Line | 262 N UNION AVE
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City | NEW BRAUNFELS
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State | TX
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Zip | 78130-4450
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Country | US
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Telephone | 830-730-6090
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Fax |
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Provider Business Mailing Address
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Address Line | 1564 ELMHURST DR
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City | LAKEHILLS
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State | TX
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Zip | 78063-6850
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Country | US
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Telephone | 325-260-8542
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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 | 81042
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License Number State | TX
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