Shoshoni Lee Viola Gensaw, MA

NPI #1710570676 in Mckinleyville, California

Provider Information

NPI Number: 1710570676
Entity Type: Individual
Name: Shoshoni Lee Viola Gensaw, MA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: MA
Enumeration Date: Feb 11, 2021
Last Updated: Feb 11, 2021

Practice Location

Address: 1560 BETTY CT
City: Mckinleyville
State: California
ZIP Code: 95519-4178
Phone: (170) 749-9257

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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