Organization
REVITALIZE COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANA M GIBILISCO MS, LPC, NCC (CEO)
(848) 459-5943
Entity
Organization
Contact information
Practice address
2401 WOODLAND RD, MANCHESTER, NJ 08759-6135
(848) 459-5943
Mailing address
2401 WOODLAND RD, MANCHESTER, NJ 08759-6135
(848) 459-5943
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00555800
NJ
Other
Enumeration date
01/12/2018
Last updated
01/12/2018
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