Individual
HEATHER ANNE GENNUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
824 DELAWARE AVE, BUFFALO, NY 14209-2006
(716) 359-5900
Mailing address
824 DELAWARE AVE, BUFFALO, NY 14209-2006
(716) 359-5900
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
001685
NY
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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