Organization
GENESIS TMS & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IFEANYI M. OLELE DO (MEDICAL DIRECTOR)
(310) 213-9945
Entity
Organization
Contact information
Practice address
10337B DEMOCRACY LN, FAIRFAX, VA 22030-2521
(703) 955-0915
Mailing address
10337 DEMOCRACY LN STE B, FAIRFAX, VA 22030-2551
(703) 955-0915
(248) 243-8804
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/09/2021
Last updated
07/27/2022
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