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General NPI Number Information
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NPI Number | 1407193873
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Entity Type | Organization
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Legal Business Name | DIANA GENZONE, LMHC, P.A.
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Dates
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Enumeration Date | 01/05/2013
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Last Update Date | 01/05/2013
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Provider Practice Location Address
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Address Line | 7100 W CAMINO REAL SUITE 302
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City | BOCA RATON
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State | FL
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Zip | 33433-5510
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Country | US
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Telephone | 561-444-8052
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Fax |
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Provider Business Mailing Address
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Address Line | 3635 LAKEWOOD PL
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City | COCONUT CREEK
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State | FL
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Zip | 33073-2248
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Country | US
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Telephone | 561-444-8052
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | MRS. DIANA GENZONE
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Credential | L.M.H.C.
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Telephone | 561-444-8052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 4672
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 8474
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License Number State | FL
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