Provider Demographics
NPI:1881464618
Name:LOZANO, GABRIELLA MARIE (LSW)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:MARIE
Last Name:LOZANO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 S CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-5053
Mailing Address - Country:US
Mailing Address - Phone:601-631-4168
Mailing Address - Fax:
Practice Address - Street 1:2720 S CLINTON AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-5053
Practice Address - Country:US
Practice Address - Phone:609-631-4168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07000000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker