Genevieve Marilyn Banegas, LCSW, PPSC Valid NPI
Individual provider · Clinical Social Worker · Fort Bragg, CA
- NPI
- 1821340480
- Type
- Individual (Type 1)
- Primary specialty
- Clinical Social Worker (Social Worker)
- Specialty group
- Behavioral Health & Social Service Providers
- Taxonomy code
- 1041C0700X
- License number
- 77553 (CA)
- Sex
- Female
- Sole proprietor
- No
- Enumerated
- 2012-10-08
- Last updated
- 2023-08-15
Practice location
205 South St
Fort Bragg, CA 95437
(707) 961-3492