Individual
RANDI JANELLE GENNARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSC, LAC
Contact information
Practice address
4414 N 19TH AVE, PHOENIX, AZ 85015-4114
(602) 285-5550
Mailing address
4414 N 19TH AVE, PHOENIX, AZ 85015-4114
(602) 285-5550
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LAC- 13883
AZ
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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