Organization
OLA WELLNESS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA AURORA RIVERA LPC (OWNER/PSYCHOTHERAPIST)
(512) 384-1407
Entity
Organization
Contact information
Practice address
1106 WEST AVE, AUSTIN, TX 78701
(512) 384-1407
Mailing address
1106 WEST AVE, AUSTIN, TX 78701-2020
(512) 384-1407
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
71270
TX
251S00000X
Community/Behavioral Health Agency
71270
TX
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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