Individual
MRS. GENOVEVA IENCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3 CROSSWOOD PL, STAFFORD, VA 22554-7839
(703) 899-8997
Mailing address
524 GARRISONVILLE RD, P.O. BOX 151, GARRISONVILLE, VA 22463
(703) 899-8997
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
1401181239
VA
Other
Enumeration date
09/08/2019
Last updated
10/09/2022
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