| Olivia Testa Soul Wellness Llc | |
| 602 Brighton Ave Portland ME 04102-2324 | |
| (603) 520-1490 | |
| Not Available | 
| Full Name | Olivia Testa Soul Wellness Llc | 
|---|---|
| Speciality | Community/behavioral Health | 
| Location | 602 Brighton Ave, Portland, Maine | 
| Authorized Official Name and Position | Olivia Pearl Testa (THERAPIST) | 
| Authorized Official Contact | 6035201490 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Olivia Testa Soul Wellness Llc 1 Lennox St Unit A Portland ME 04103-5513 Ph: (603) 520-1490 | Olivia Testa Soul Wellness Llc 602 Brighton Ave Portland ME 04102-2324 Ph: (603) 520-1490 | 
| NPI Number | 1316604879 | 
|---|---|
| Provider Enumeration Date | 11/19/2021 | 
| Last Update Date | 11/19/2021 | 
| Certification Date | 11/19/2021 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1316604879 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary | 
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