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1184447955
PSYCH REVIVAL THERAPY LLC
SPRINGFIELD, MO
NPI
1184447955
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Entity Type
Organization
Authorized Contact
NICHOLE SPROWSO
CEO
970-208-7791
Organization Subpart ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2024-11-01
Last Update Date
2024-11-01
Business Address
PSYCH REVIVAL THERAPY LLC
1675 E SEMINOLE ST
SPRINGFIELD, MO 65804-2490
Phone number: 970-208-7791
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Mailing Address
PSYCH REVIVAL THERAPY LLC
3097 N DICKERSON AVE
SPRINGFIELD, MO 65803-1267
Phone number: 970-208-7791
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