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Organization

CONTIGO WELLNESS FOUNDATION

Active
Other names
Contigo Wellness, Contigo Wellness
Organization subpart
No

Provider details

NPI number
Authorized official
DIANA ANZALDUA LCSW (PRESIDENT)
(512) 937-2640
Entity
Organization

Contact information

Practice address
111 RAMBLE LN STE 120, AUSTIN, TX 78745-2281
(512) 937-2640
Mailing address
111 RAMBLE LN STE 120, AUSTIN, TX 78745-2281
(512) 937-2640

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
225XM0800X
Mental Health Occupational Therapist
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
123456
SELF-PAY
TX
Enumeration date
11/20/2021
Last updated
11/20/2021
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