Individual
MS. GINA MARIE FUNICELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
274 MAIN ST N, BETHLEHEM, CT 06751-1401
(203) 910-6926
Mailing address
274 MAIN ST N, BETHLEHEM, CT 06751-1401
(203) 910-6926
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3144
CT
Other
Enumeration date
09/10/2020
Last updated
09/10/2020
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