NPI 1104439413

Miva Psychotherapy

Organisation Professional Counselor St Charles, IL

Practice location

Address: 475 Dunham Rd STE 1e, St Charles, IL 60174-1498
Phone: (331) 276-2355
Mailing address: 590 E Thorndale Ln, South Elgin, IL 60177-3205

Authorised official

Name: Ayaovi Esenam Amezotchi
Title: Therapist
Phone: (630) 674-2405

Registered specialties

Professional Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YP2500X

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Registry record

NPI: 1104439413
Entity type: Organization
NPI issued: 26 Aug 2020
Record last updated: 3 Oct 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.