Organization
RITUAL WELLNESS ATX PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON LEIGH STAVINOHA PHD (LICENSED PSYCHOLOGIST)
(903) 914-0224
Entity
Organization
Contact information
Practice address
4131 SPICEWOOD SPRINGS RD STE I7, AUSTIN, TX 78759-8659
(903) 914-0224
Mailing address
PO BOX 170073, AUSTIN, TX 78717-0004
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/13/2021
Last updated
09/16/2021
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