Individual
MS. GINA MARIE BAUDILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
47 HEIGHTS RD, NORTHPORT, NY 11768-2630
(631) 662-1588
Mailing address
47 HEIGHTS RD, NORTHPORT, NY 11768-2630
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001481
NY
Other
Enumeration date
06/19/2018
Last updated
06/19/2018
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