Provider Demographics
NPI:1174216832
Name:GUZMAN, JENNIFER ASHLEY (LPC-A)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ASHLEY
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1494
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-1494
Mailing Address - Country:US
Mailing Address - Phone:972-265-9258
Mailing Address - Fax:
Practice Address - Street 1:5125 HUBBARD CT
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-4148
Practice Address - Country:US
Practice Address - Phone:972-265-9258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88902101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health