Revive Psychological Services P.c.

NPI #1407146376 in Woodridge, Illinois

Provider Information

NPI Number: 1407146376
Entity Type: Organization
Organization Name: Revive Psychological Services P.c.
Primary Specialty: Psychologist - Clinical
Enumeration Date: Apr 13, 2011
Last Updated: Apr 13, 2011

Practice Location

Address: 1420 TOWER HILL DR
City: Woodridge
State: Illinois
ZIP Code: 60517-7674
Phone: (312) 961-1557

Authorized Official

Name: DR. GEETHA MUNISAMY, PH.D.
Title: DIRECTOR
Phone: (312) 961-1557

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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