Provider Demographics
NPI:1003001413
Name:RABBITT, GINA MARIE (MS)
Entity Type:Individual
Prefix:MISS
First Name:GINA
Middle Name:MARIE
Last Name:RABBITT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RED JACKET LN
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-6839
Mailing Address - Country:US
Mailing Address - Phone:339-221-0560
Mailing Address - Fax:
Practice Address - Street 1:172 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-4815
Practice Address - Country:US
Practice Address - Phone:978-744-1386
Practice Address - Fax:978-740-4996
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS15495922101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health