Organization Name: | OLIVE BRANCH COUNSELING AND TRAINING, PLLC |
NPI Number: | 1013307966 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMY WILSON (OWNER) |
Mailing Address: | 31320 Interstate 10 W Suite E Boerne |
State: | TX US |
Postal Code: | 780065027 |
Phone Number: | 2105644310 |
Fax Number: | 8307752369 |
NPI Enumeration Date: | 01/30/2015 |
NPI Last Update Date: | 01/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 70073 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |