Healthcare Provider Details

I. General information

NPI: 1790084036
Provider Name (Legal Business Name): WENDY L. OLMSTEAD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. WENDY L. YOCUM

II. Dates (important events)

Enumeration Date: 03/25/2011
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4910 AIRPORT AVE STE D
ROSENBERG TX
77471-5759
US

IV. Provider business mailing address

4910 AIRPORT AVE STE D
ROSENBERG TX
77471-5759
US

V. Phone/Fax

Practice location:
  • Phone: 979-532-6118
  • Fax: 979-532-0312
Mailing address:
  • Phone: 979-532-6118
  • Fax: 979-532-0312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number65382
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: