Individual
MR. VINCENT JOHN GENNACO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
6 NORMAN ST, SALEM, MA 01970-3314
(978) 745-5114
(781) 631-5537
Mailing address
6 NORMAN ST, SALEM, MA 01970-3314
(978) 745-5114
(781) 631-5537
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
359
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0503789
—
MA
Enumeration date
06/17/2006
Last updated
07/07/2010
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