Genesi LLC

NPI #1669767257 in Moore, Oklahoma

Provider Information

NPI Number
1669767257
Entity Type
Organization
Organization Name
Genesi LLC
Primary Specialty
Community/Behavioral Health
Enumeration Date
Jun 13, 2011
Last Updated
Jun 13, 2011

Practice Location

Address
626 N BROADWAY ST
City
Moore
ZIP Code
73160-4814
Phone
(405) 626-1711

Authorized Official

Name
MS. ROSANNE JILL NARDONI ISOM, LPC
Title
CEO/LPC
Phone
(405) 626-2544

Specialties & Taxonomy Codes

Specialty
Community/Behavioral Health

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