Individual
MR. JOHN THEODORE GENAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MLADC
Contact information
Practice address
1228 ELM ST, MANCHESTER, NH 03101-1349
(603) 668-4111
(603) 628-7757
Mailing address
401 CYPRESS ST, MANCHESTER, NH 03103-3628
(603) 668-4111
(603) 628-7757
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0411
NH
Other
Enumeration date
06/09/2011
Last updated
07/06/2011
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