Provider Demographics
NPI:1295301703
Name:FERREIRO, GINA (MA, BCBA)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:FERREIRO
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1273 ROBERT ST
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205-2425
Mailing Address - Country:US
Mailing Address - Phone:908-943-2762
Mailing Address - Fax:
Practice Address - Street 1:1851 OLD CUTHBERT RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1415
Practice Address - Country:US
Practice Address - Phone:856-631-1223
Practice Address - Fax:484-320-8307
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJBACB496588103K00000X
NJ1-21-49226103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst