Organization
REVIVE PSYCHOLOGICAL SERVICES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEETHA MUNISAMY PH.D. (DIRECTOR)
(312) 961-1557
Entity
Organization
Contact information
Practice address
1420 TOWER HILL DR, WOODRIDGE, IL 60517-7674
(312) 961-1557
Mailing address
1420 TOWER HILL DRIVE, WOODRIDGE, IL 60517-7674
(312) 961-1557
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008111
IL
Other
Enumeration date
04/13/2011
Last updated
04/13/2011
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