Healthcare Provider Details

I. General information

NPI: 1144988809
Provider Name (Legal Business Name): NATALIA OLVERA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 TENNESSEE DR
EULESS TX
76040-4691
US

IV. Provider business mailing address

815 TENNESSEE DR
EULESS TX
76040-4691
US

V. Phone/Fax

Practice location:
  • Phone: 214-802-6504
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number66871
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: