Individual
GENESIS ROQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAPC
Contact information
Practice address
750 E BROAD ST, HAZLETON, PA 18201-6835
(570) 455-6385
Mailing address
4 RITTENHOUSE PL, DRUMS, PA 18222-2744
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APC000752
PA
Other
Enumeration date
06/27/2023
Last updated
03/16/2026
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