Provider Demographics
NPI:1841990033
Name:MANFRINI, GAIA (MA)
Entity type:Individual
Prefix:
First Name:GAIA
Middle Name:
Last Name:MANFRINI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 S RIDGEWOOD AVE APT 2414
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-3529
Mailing Address - Country:US
Mailing Address - Phone:321-594-8689
Mailing Address - Fax:
Practice Address - Street 1:3230 S RIDGEWOOD AVE APT 2414
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-3529
Practice Address - Country:US
Practice Address - Phone:321-594-8689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty