Organization
REVIVE TO THRIVE WELLNESS CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY ANN PARKER MA, MSLPC, LCDC (OWNER, LEAD THERAPIST)
(972) 885-8365
Entity
Organization
Contact information
Practice address
5050 QUORUM DR STE 700, DALLAS, TX 75254-1410
(972) 885-8365
Mailing address
5050 QUORUM DR STE 700, DALLAS, TX 75254-1410
(972) 885-8365
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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