Provider Demographics
NPI:1174059745
Name:GERACI, ANN VAYO (MASTERS)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:VAYO
Last Name:GERACI
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:THERESE
Other - Last Name:VAYO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:460 LITTLE NECK RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-5769
Mailing Address - Country:US
Mailing Address - Phone:757-560-5438
Mailing Address - Fax:
Practice Address - Street 1:5163 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6501
Practice Address - Country:US
Practice Address - Phone:757-497-4703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician