Provider Demographics
NPI:1720412026
Name:TANZ, GILLIAN BARBARA (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:GILLIAN
Middle Name:BARBARA
Last Name:TANZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 FILLOW ST
Mailing Address - Street 2:UNIT 3
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-2841
Mailing Address - Country:US
Mailing Address - Phone:203-912-9665
Mailing Address - Fax:
Practice Address - Street 1:18 NAROMAKE AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-4707
Practice Address - Country:US
Practice Address - Phone:203-912-9665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker