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Individual
MR. ISMAEL EDGE GERENA JR.
Active
Individual
MR. ISMAEL EDGE GERENA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LMHCA, LMFTA
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MC60449151
WA
106H00000X
Marriage & Family Therapist
MG60449387
WA
Other
Enumeration date
04/18/2014
Last updated
07/02/2015
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