Revive Wellness
NPI #1912443094 in Conshohocken, Pennsylvania
Provider Information
- NPI Number
- 1912443094
- Entity Type
- Organization
- Organization Name
- Revive Wellness
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Jan 12, 2017
- Last Updated
- May 4, 2017
Practice Location
- Address
- 119 HARRY ST
- Address 2
- FIRST FLOOR
- City
- Conshohocken
- State
- Pennsylvania
- ZIP Code
- 19428
- Phone
- (610) 457-8542
Authorized Official
- Name
- LEIZA STANLEY, LCSW
- Title
- OWNER
- Phone
- (640) 457-8542
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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