Provider Information for 1689198848
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GENNA RISUCCI CINCOGRONO LMHC
Other Names:Former Name:GENNA LYN RISUCCI LMHCSex: Female
NPI: 1689198848
Last Updated: 2022-06-12
Certification Date: 2022-06-12
Certification Date: 2022-06-12
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1689198848 | ||||||||
| Enumeration Date | 2017-07-31 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 115 W WOOLBRIGHT RD STE J BOYNTON BEACH, FL 33435-5908 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 1001 W COMMERCIAL BLVD FT LAUDERDALE, FL 33309-3107 United States Phone: 561-734-1818 | Fax: | ||||||||
| Secondary Practice Address(es) | 115 W WOOLBRIGHT RD BLDG 2 | ||||||||
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