Individual
MS. CONNIE M DE GENNARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
93 W PALISADE AVE, ENGLEWOOD, NJ 07631-2611
(201) 567-0500
(201) 567-9335
Mailing address
93 W PALISADE AVE, ENGLEWOOD, NJ 07631-2611
(201) 567-0500
(201) 567-9335
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00012100
NJ
Other
Enumeration date
02/01/2007
Last updated
07/08/2007
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