Provider Demographics
NPI:1306102967
Name:REYNA-WORTHINGTON, JESSICA LYNN (MS)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:REYNA-WORTHINGTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 W 10TH ST
Mailing Address - Street 2:SUITE 302-B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-2047
Mailing Address - Country:US
Mailing Address - Phone:512-537-5977
Mailing Address - Fax:
Practice Address - Street 1:805 W 10TH ST
Practice Address - Street 2:SUITE 302-B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2047
Practice Address - Country:US
Practice Address - Phone:512-537-5977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor