Provider Demographics
NPI:1659026201
Name:RENDINO, GENNA (MA)
Entity Type:Individual
Prefix:
First Name:GENNA
Middle Name:
Last Name:RENDINO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 S CLINTON ST STE 211
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4220
Mailing Address - Country:US
Mailing Address - Phone:215-817-0190
Mailing Address - Fax:
Practice Address - Street 1:10 S CLINTON ST STE 211
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4220
Practice Address - Country:US
Practice Address - Phone:215-817-0190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-12
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health