Provider Demographics
NPI:1790569697
Name:MENNINGER, GINA MARIE (MFT-TRNE)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MARIE
Last Name:MENNINGER
Suffix:
Gender:F
Credentials:MFT-TRNE
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:MARIE
Other - Last Name:MOSCORELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1557 LAFAYETTE DR APT A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-6828
Mailing Address - Country:US
Mailing Address - Phone:440-263-2009
Mailing Address - Fax:
Practice Address - Street 1:495 E MOUND ST STE 110
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5596
Practice Address - Country:US
Practice Address - Phone:614-948-3273
Practice Address - Fax:855-740-2025
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHM.2300351-TRNE106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist