| Miva Psychotherapy | |
|
475 Dunham Rd Ste 1e St Charles IL 60174-1498 | |
| (331) 276-2355 | |
| Not Available |
| Full Name | Miva Psychotherapy |
|---|---|
| Speciality | Counselor - Professional |
| Location | 475 Dunham Rd Ste 1e, St Charles, Illinois |
| Authorized Official Name and Position | Ayaovi Esenam Amezotchi (THERAPIST) |
| Authorized Official Contact | 6306742405 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miva Psychotherapy 590 E Thorndale Ln South Elgin IL 60177-3205 Ph: (630) 674-2405 | Miva Psychotherapy 475 Dunham Rd Ste 1e St Charles IL 60174-1498 Ph: (331) 276-2355 |
| NPI Number | 1104439413 |
|---|---|
| Provider Enumeration Date | 08/26/2020 |
| Last Update Date | 10/03/2020 |
| Certification Date | 10/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104439413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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