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General NPI Number Information
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NPI Number | 1801277413
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Entity Type | Individual
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Provider Name | GINA MAZZA MS, BCBA
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Gender | Female
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Dates
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Enumeration Date | 06/10/2015
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 262 SWANSEA MALL DR STE 701
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City | SWANSEA
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State | MA
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Zip | 02777-4151
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Country | US
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Telephone | 877-418-2978
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Fax |
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Provider Business Mailing Address
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Address Line | 350 FAIRWAY DR STE 101
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City | DEERFIELD BEACH
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State | FL
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Zip | 33441-1834
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Country | US
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Telephone | 877-418-2978
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Fax | 866-500-2186
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | C082014000328
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | MA
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