Provider Demographics
NPI:1174877518
Name:FERRARESI, GINA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:FERRARESI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BELMONT ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-1402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1R NEWBURY ST
Practice Address - Street 2:SUITE 303
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-3864
Practice Address - Country:US
Practice Address - Phone:617-529-1573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8604235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist