Provider Demographics
NPI:1629541883
Name:GENNA DURANTE, PH.D., PLLC
Entity type:Organization
Organization Name:GENNA DURANTE, PH.D., PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DURANTE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:425-549-4812
Mailing Address - Street 1:125 ELFIN HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:VT
Mailing Address - Zip Code:05445-9735
Mailing Address - Country:US
Mailing Address - Phone:802-338-1464
Mailing Address - Fax:
Practice Address - Street 1:311 207TH AVE NE
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-6938
Practice Address - Country:US
Practice Address - Phone:425-549-4812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-09
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty