Provider Demographics
NPI:1821413824
Name:HART, GENA R
Entity Type:Individual
Prefix:
First Name:GENA
Middle Name:R
Last Name:HART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-2052
Mailing Address - Country:US
Mailing Address - Phone:302-439-4951
Mailing Address - Fax:302-439-4957
Practice Address - Street 1:3301 GREEN ST
Practice Address - Street 2:
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2052
Practice Address - Country:US
Practice Address - Phone:302-439-4951
Practice Address - Fax:302-439-4957
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor