Individual
DR. MICHAEL J GENNARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
463B CARLISLE DRIVE, HERNDON, VA 20170
(703) 481-0031
(703) 481-0056
Mailing address
PO BOX 5101, HERNDON, VA 20172
(703) 481-0031
(703) 481-0056
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001740
VA
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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