Provider Demographics
NPI:1245957406
Name:BROWN, GINA VALENTINA (ND)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:VALENTINA
Last Name:BROWN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 FAIRFIELD PL
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5604
Mailing Address - Country:US
Mailing Address - Phone:203-254-9957
Mailing Address - Fax:203-254-9343
Practice Address - Street 1:22 FAIRFIELD PL
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5604
Practice Address - Country:US
Practice Address - Phone:203-254-9957
Practice Address - Fax:203-254-9343
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath