Healthcare Provider Details

I. General information

NPI: 1386357226
Provider Name (Legal Business Name): OLIVIA N VEROSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 E PARK ST
CEDAR PARK TX
78613-4598
US

IV. Provider business mailing address

2105 E PARK ST
CEDAR PARK TX
78613-4598
US

V. Phone/Fax

Practice location:
  • Phone: 512-588-1362
  • Fax: 512-792-4834
Mailing address:
  • Phone: 512-588-1362
  • Fax: 512-792-4834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBHV-010404
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: