Organization
BACK TO LIFE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JALISA GILES LCSW (OWNER/PSYCHOTHERAPIST)
(512) 270-9622
Entity
Organization
Contact information
Practice address
701 TILLERY ST STE 12, AUSTIN, TX 78702-3751
(713) 941-9777
Mailing address
701 TILLERY ST STE 12, AUSTIN, TX 78702-3751
(512) 270-9622
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/18/2026
Last updated
04/10/2026
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