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General NPI Number Information
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NPI Number | 1871221002
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Entity Type | Organization
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Legal Business Name | REAL WELL THERAPY, PLLC
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 3625 MENCHACA RD STE 202
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City | AUSTIN
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State | TX
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Zip | 78704-5912
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Country | US
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Telephone | 713-870-4059
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Fax |
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Provider Business Mailing Address
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Address Line | 702 E NEW BRAUNFELS ST
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City | SEGUIN
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State | TX
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Zip | 78155-2835
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | LISA OSBORN
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Credential |
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Telephone | 713-870-4059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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