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Organization
HIATUS WELLNESS LLC
Active
Organization
HIATUS WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER DENITRA POPOVICH LPC-S (OWNER)
(512) 522-9811
Entity
Organization
Contact information
Practice address
1205 N HWY 123 STE 305, SAN MARCOS, TX 78666-7756
(512) 522-9811
(888) 974-0284
Mailing address
1205 N HWY 123 STE 305, SAN MARCOS, TX 78666-7756
(512) 522-9811
(888) 974-0284
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/13/2020
Last updated
11/13/2020
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