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Organization
REVIVE THERAPY LLC
Active
Organization
REVIVE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE CEYLER LPCC-S, LICDC-CS (OWNER/THERAPIST)
(937) 216-3904
Entity
Organization
Contact information
Practice address
405 PUBLIC SQ STE 350, TROY, OH 45373-5200
(937) 980-3252
Mailing address
514 PETERS AVE, TROY, OH 45373-3976
(937) 216-3904
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275087454
—
OH
Enumeration date
08/04/2023
Last updated
08/04/2023
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