Organization
GENESI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSANNE JILL NARDONI ISOM LPC (CEO/LPC)
(405) 626-2544
Entity
Organization
Contact information
Practice address
626 N BROADWAY ST, MOORE, OK 73160-4814
(405) 626-1711
(405) 895-7544
Mailing address
626 N BROADWAY ST, MOORE, OK 73160-4814
(405) 626-1711
(405) 895-7544
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
OK
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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