Provider Demographics
NPI:1508373192
Name:APICELLA, GINA (BCBA)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:APICELLA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 WHITE DR
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-2633
Mailing Address - Country:US
Mailing Address - Phone:203-641-2986
Mailing Address - Fax:
Practice Address - Street 1:49 WHITE DR
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-2633
Practice Address - Country:US
Practice Address - Phone:203-641-2986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst