MEDICARE: MRS. STELLA A OLISE L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	65847	TX

General Provider Information

NPI Number	:	1649556754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STELLA A OLISE L.P.C.

Provider Business Mailing Address
First Line	:	9800 PAGEWOOD LN
Second Line	:	SUITE 2704
City	:	HOUSTON
State	:	TX
Zip	:	77042-5530
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9800 PAGEWOOD LN
Second Line	:	SUITE 2704
City	:	HOUSTON
State	:	TX
Zip	:	77042-5530
Country	:	US
Telephone Number	:	713-992-8156
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2011
Last Update Date	:	09/16/2013

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