Provider Demographics
NPI:1588243331
Name:MARIANI, GINA ALESSANDRA (MSW, LISW)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:ALESSANDRA
Last Name:MARIANI
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7015 SPRING MEADOWS DR W STE 106
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-7200
Mailing Address - Country:US
Mailing Address - Phone:567-694-6632
Mailing Address - Fax:419-491-7111
Practice Address - Street 1:7015 SPRING MEADOWS DR W STE 106
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-7200
Practice Address - Country:US
Practice Address - Phone:567-694-6632
Practice Address - Fax:419-491-7111
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1903843104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker