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General NPI Number Information
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NPI Number | 1477441400
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Entity Type | Individual
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Provider Name | JAQUELINE LEE OLVERA LPC-ASSOCIATE
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Gender | Female
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 1213 W SLAUGHTER LN STE 130
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City | AUSTIN
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State | TX
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Zip | 78748-6904
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Country | US
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Telephone | 512-640-2134
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Fax |
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Provider Business Mailing Address
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Address Line | 8003 S INTERSTATE 35 APT 2934
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City | AUSTIN
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State | TX
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Zip | 78744-0091
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Country | US
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Telephone | 361-401-1893
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 98977
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License Number State | TX
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