Provider Demographics
NPI:1598443137
Name:GINELLA, ANDREA JOSEPHINE
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JOSEPHINE
Last Name:GINELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8519 HIGH MILL AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANAL FULTON
Mailing Address - State:OH
Mailing Address - Zip Code:44614-8841
Mailing Address - Country:US
Mailing Address - Phone:330-324-3824
Mailing Address - Fax:
Practice Address - Street 1:6200 LANDERHAVEN DR
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-4129
Practice Address - Country:US
Practice Address - Phone:216-245-3661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist