Provider Demographics
NPI:1881028124
Name:SCAFA, GINA (MS, CCC - SLP)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:SCAFA
Suffix:
Gender:F
Credentials:MS, CCC - SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 WEST RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05408-2401
Mailing Address - Country:US
Mailing Address - Phone:802-865-4645
Mailing Address - Fax:
Practice Address - Street 1:38 WEST RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05408-2401
Practice Address - Country:US
Practice Address - Phone:802-865-4645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT6-84235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist