| Olive Branch Counseling And Training, Pllc | |
|
31320 Interstate 10 W Suite E Boerne TX 78006-5027 | |
| (210) 564-4310 | |
| (830) 775-2369 |
| Full Name | Olive Branch Counseling And Training, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 31320 Interstate 10 W, Boerne, Texas |
| Authorized Official Name and Position | Amy Wilson (OWNER) |
| Authorized Official Contact | 2105644310 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Olive Branch Counseling And Training, Pllc 31320 Interstate 10 W Suite E Boerne TX 78006-5027 Ph: (210) 564-4310 | Olive Branch Counseling And Training, Pllc 31320 Interstate 10 W Suite E Boerne TX 78006-5027 Ph: (210) 564-4310 |
| NPI Number | 1013307966 |
|---|---|
| Provider Enumeration Date | 01/30/2015 |
| Last Update Date | 01/30/2015 |
| Medicare PECOS PAC ID | 2163844432 |
|---|---|
| Medicare Enrollment ID | O20200622000503 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013307966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 70073 (Texas) | Primary |
| Provider Name | Jonette S Coquat |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801938410 PECOS PAC ID: 3870812555 Enrollment ID: I20150430001217 |
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