| NPI | 1326535477 |
|---|---|
| Doing Business As | REVIVE COUNSELING |
| Entity Type | Organization |
| Authorized Contact | NICHOLAS LAMAR TEW Owner 601-718-0328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MS C6882) |
| Enumeration Date | 2018-04-14 |
| Last Update Date | 2018-04-14 |