Provider Demographics
NPI:1861041246
Name:TALAMANTEZ, JESSICA PAULINE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:PAULINE
Last Name:TALAMANTEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2423 FALLS CHURCH DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-1253
Mailing Address - Country:US
Mailing Address - Phone:832-289-1644
Mailing Address - Fax:
Practice Address - Street 1:25511 BUDDE RD
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2080
Practice Address - Country:US
Practice Address - Phone:281-719-5539
Practice Address - Fax:281-715-4742
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76199101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX02247698OtherDRIVER'S LICENSE NUMBER