Organization
MENTAL HEALTH PRO PA REVIVED WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA ENEYI ABOLARIN (OWNER OF ENTITY)
(818) 300-9424
Entity
Organization
Contact information
Practice address
4400 S PIEDRAS DR STE 217, SAN ANTONIO, TX 78228-1223
(210) 903-3383
Mailing address
7475 CALLAGHAN RD, SAN ANTONIO, TX 78229-2969
(210) 903-3383
(210) 544-5194
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/24/2025
Last updated
03/05/2026
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