Organization
MANDALA RESTORATIVE THERAPY
Active
Other names
Mandala Restorative Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TESSA MARIE MANDALA LCPC (OWNER/LICENSED CLINICIAN)
(602) 821-7850
Entity
Organization
Contact information
Practice address
5215 N RAVENSWOOD AVE STE 214, CHICAGO, IL 60640-1670
(602) 821-7850
Mailing address
5215 N RAVENSWOOD AVE STE 214, CHICAGO, IL 60640-1670
(602) 821-7850
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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