Individual provider · Type 1 NPI
Corissa Gidula, MA, BCBA
Mental Health Counselor · Manahawkin, NJ
NPI number
1821455692
Active
Practice location
848 Buccaneer Ln
Manahawkin, NJ 08050-2112
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst | 103K00000X | 1-22-59762 (NJ) |
| Mental Health Counselor Primary | 101YM0800X | APC004512 (GA) |
Mental Health Counselor: Definition to come...
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About NPI 1821455692
Corissa Gidula, MA, BCBA's National Provider Identifier is 1821455692, issued on Jan 25, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Manahawkin, NJ. The record was last updated on Feb 28, 2023.