Organization
REVIVE HEALING & WELLNESS INSTITUTE, LLC.
Active
Other names
Revive Healing & Wellness Institute, LLC.
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA BAUMAN LMFT (PARTNER)
(509) 985-8788
Entity
Organization
Contact information
Practice address
970 SIDNEY MARCUS BLVD NE UNIT 1412, ATLANTA, GA 30324-3160
(404) 500-9494
Mailing address
970 SIDNEY MARCUS BLVD NE UNIT 1412, ATLANTA, GA 30324-3160
(404) 500-9494
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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