Individual
GABRIELLA CORIN PINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1055 FARMINGTON AVE, FARMINGTON, CT 06032-1573
(818) 241-6780
Mailing address
1055 E COLORADO BLVD STE 560, PASADENA, CA 91106-2380
(818) 241-6780
(818) 241-6853
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
038172652
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XGT0971848496
BLUE CROSS BLUE SHIELD
CT
Enumeration date
04/14/2021
Last updated
04/14/2021
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