Provider Demographics
NPI:1760362131
Name:ALLEN, GINA LAURIE
Entity type:Individual
Prefix:MRS
First Name:GINA
Middle Name:LAURIE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:GINA
Other - Middle Name:LAURIE
Other - Last Name:CIARAMETARO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-1726
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 ESSEX CENTER DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2959
Practice Address - Country:US
Practice Address - Phone:887-969-4460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician