Provider Demographics
NPI:1053728162
Name:JESSICA MARIE ALANIZ
Entity type:Organization
Organization Name:JESSICA MARIE ALANIZ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ALANIZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:817-658-6708
Mailing Address - Street 1:3411 AUTUMN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-8057
Mailing Address - Country:US
Mailing Address - Phone:817-658-6708
Mailing Address - Fax:
Practice Address - Street 1:9901 VALLEY RANCH PKWY E
Practice Address - Street 2:SUITE 2039
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-4730
Practice Address - Country:US
Practice Address - Phone:817-658-6708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68434101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty