Provider Demographics
NPI:1902039886
Name:ONOFRIO, GAIL M (MS)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:M
Last Name:ONOFRIO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 HIGH ST
Mailing Address - Street 2:P.O. BOX 897
Mailing Address - City:DEEP RIVER
Mailing Address - State:CT
Mailing Address - Zip Code:06417-1932
Mailing Address - Country:US
Mailing Address - Phone:860-526-3600
Mailing Address - Fax:860-526-3600
Practice Address - Street 1:56 HIGH ST
Practice Address - Street 2:
Practice Address - City:DEEP RIVER
Practice Address - State:CT
Practice Address - Zip Code:06417-1932
Practice Address - Country:US
Practice Address - Phone:860-526-3600
Practice Address - Fax:860-526-3600
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000215101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health