| Rosalie Genova, Lcpc, Ccs | |
|
1250 Forest Ave Portland Wellness Cooperative, Unit 14, Suite 7 Portland ME 04103 | |
| (207) 200-3789 | |
| Not Available |
| Full Name | Rosalie Genova, Lcpc, Ccs |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1250 Forest Ave, Portland, Maine |
| Authorized Official Name and Position | Rosalie Genova (OWNER) |
| Authorized Official Contact | 2072003789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosalie Genova, Lcpc, Ccs 1250 Forest Ave Portland Wellness Cooperative, Unit 14, Suite 7 Portland ME 04103 Ph: () - | Rosalie Genova, Lcpc, Ccs 1250 Forest Ave Portland Wellness Cooperative, Unit 14, Suite 7 Portland ME 04103 Ph: (207) 200-3789 |
| NPI Number | 1134837222 |
|---|---|
| Provider Enumeration Date | 11/08/2022 |
| Last Update Date | 11/08/2022 |
| Certification Date | 11/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134837222 | NPI | - | NPPES |
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