| Mary Giencke | |
|
609 Independence Pkwy Suite 115 Chesapeake VA 23320-5209 | |
| (757) 490-0377 | |
| Not Available |
| Full Name | Mary Giencke |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 609 Independence Pkwy, Chesapeake, Virginia |
| Authorized Official Name and Position | Mary Giencke (LPC) |
| Authorized Official Contact | 7574900377 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Giencke 609 Independence Pkwy Suite 115 Chesapeake VA 23320-5209 Ph: (757) 490-0377 | Mary Giencke 609 Independence Pkwy Suite 115 Chesapeake VA 23320-5209 Ph: (757) 490-0377 |
| NPI Number | 1588106801 |
|---|---|
| Provider Enumeration Date | 11/17/2016 |
| Last Update Date | 12/07/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588106801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0701006852 (Virginia) | Primary |
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