Provider Demographics
NPI:1831667583
Name:MCCLANAHAN, GENORA E (LIFE COACH, MINISTER)
Entity Type:Individual
Prefix:MS
First Name:GENORA
Middle Name:E
Last Name:MCCLANAHAN
Suffix:
Gender:F
Credentials:LIFE COACH, MINISTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21303
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93390
Mailing Address - Country:US
Mailing Address - Phone:661-664-9646
Mailing Address - Fax:
Practice Address - Street 1:9225 LANNEAU COURT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9331
Practice Address - Country:US
Practice Address - Phone:661-664-9646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty