Organization
OLIVE TREE MATERNAL WELLNESS CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE MATEO LPC, LMHC (OWNER)
(770) 896-2659
Entity
Organization
Contact information
Practice address
2465 US HIGHWAY 1 S, ST AUGUSTINE, FL 32086-6076
(770) 896-2659
Mailing address
2465 US HIGHWAY 1 S, ST AUGUSTINE, FL 32086-6076
(770) 896-2659
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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