| Revive Relationship Therapy Inc. | |
|
1967 N Dayton St Chicago IL 60614 | |
| (312) 714-5168 | |
| Not Available |
| Full Name | Revive Relationship Therapy Inc. |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1967 N Dayton St, Chicago, Illinois |
| Authorized Official Name and Position | Amanda Berry (OWNER) |
| Authorized Official Contact | 3127145168 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Revive Relationship Therapy Inc. 1236 W Webster Ave # 1 Chicago IL 60614-3140 Ph: (312) 714-5168 | Revive Relationship Therapy Inc. 1967 N Dayton St Chicago IL 60614 Ph: (312) 714-5168 |
| NPI Number | 1366965394 |
|---|---|
| Provider Enumeration Date | 07/21/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366965394 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 166.01099 (Illinois) | Primary |
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