Individual
DR. ELAINE SUSAN REVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
23811 CHAGRIN BLVD STE 310, BEACHWOOD, OH 44122-5525
(216) 464-1277
Mailing address
23811 CHAGRIN BLVD STE 310, BEACHWOOD, OH 44122-5525
(216) 464-1277
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6207
OH
Other
Enumeration date
07/30/2006
Last updated
07/08/2007
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