Individual
MYAH A REVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
159 RAMSDEN AVE, LA VERGNE, TN 37086-1485
(513) 714-2562
Mailing address
159 RAMSDEN AVE, LA VERGNE, TN 37086-1485
(513) 714-2562
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
NA
MS
Other
Enumeration date
07/07/2025
Last updated
07/07/2025
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