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Organization
REVERIE CREATIVE ARTS THERAPY SERVICES, PLLC
Active
Organization
REVERIE CREATIVE ARTS THERAPY SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MACKENZIE GILLETT GILLETT LCAT, ATR-BC (THERAPIST/OWNER)
(315) 783-8191
Entity
Organization
Contact information
Practice address
7000 E GENESEE ST STE D, FAYETTEVILLE, NY 13066-1131
(315) 783-8191
Mailing address
6494 COLTON RD, LA FAYETTE, NY 13084-9658
(315) 783-8191
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/10/2024
Last updated
01/10/2024
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