| NPI | 1598511586 |
|---|---|
| Former Legal Business Name | VIVIFY THERAPY |
| Entity Type | Organization |
| Authorized Contact | JENNIFER NASH Owner/Provider 315-873-2936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2024-04-29 |
| Last Update Date | 2024-04-29 |