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Organization
REVIVE RELATIONSHIP THERAPY INC.
Active
Organization
REVIVE RELATIONSHIP THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA BERRY (OWNER)
(312) 714-5168
Entity
Organization
Contact information
Practice address
1967 N DAYTON ST, CHICAGO, IL 60614
(312) 714-5168
Mailing address
1236 W WEBSTER AVE # 1, CHICAGO, IL 60614-3140
(312) 714-5168
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
166.01099
IL
Other
Enumeration date
07/21/2017
Last updated
07/21/2022
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