MEDICARE: MRS. GINA M PAZZAGLIA LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LSW 2189	OK

General Provider Information

NPI Number	:	1215090717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GINA M PAZZAGLIA LCSW

Provider Business Mailing Address
First Line	:	9404 BUTTONWOOD AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73160-9137
Country	:	US
Telephone Number	:	405-237-3780
Fax Number	:	405-237-3781

Provider Business Practice Location Address
First Line	:	2310 SW 89TH ST STE D
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-6313
Country	:	US
Telephone Number	:	405-735-9777
Fax Number	:	405-735-9888

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	02/10/2026

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