| NPI | 1821665191 |
|---|---|
| Doing Business As | REVIVE COUNSELING ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | BRIAN COOK Member 570-262-4788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-06-07 |
| Last Update Date | 2021-08-02 |