Provider Demographics
NPI:1356079826
Name:MAURIZIO, GINA MARIA (CAC)
Entity type:Individual
Prefix:MS
First Name:GINA
Middle Name:MARIA
Last Name:MAURIZIO
Suffix:
Gender:F
Credentials:CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 NOD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:CT
Mailing Address - Zip Code:06413-1614
Mailing Address - Country:US
Mailing Address - Phone:203-631-2734
Mailing Address - Fax:
Practice Address - Street 1:71 CATLIN ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-4248
Practice Address - Country:US
Practice Address - Phone:203-631-2734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty