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Organization
RAISING THE GROUND
Active
Organization
RAISING THE GROUND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY OTA LPC (OWNER, THERAPIST)
(512) 815-3723
Entity
Organization
Contact information
Practice address
595 ROUND ROCK WEST DR STE 104, ROUND ROCK, TX 78681-5028
(512) 815-3723
Mailing address
595 ROUND ROCK WEST DR STE 104, ROUND ROCK, TX 78681-5028
(512) 815-3723
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043751787
NPI
TX
01
—
1871002311
NPI
TX
Enumeration date
02/16/2019
Last updated
03/18/2019
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