| Doctor Name: | MRS. GINA M CIVEROLO |
| NPI Number: | 1295714970 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. LPCC DAPA |
| License Number: | 1482 |
| Business Practice Address: | 2450 Alamo Ave Se C/o Asap Albuquerque, NM - 871063204 |
| Business Phone Number: | 5059252400 |
| Business Fax Number: | 5059252411 |
| Mailing Address: | 933 Bradbury Dr Se, ALBUQUERQUE |
| State: | NM |
| Postal Code: | 871064374 |
| Phone Number: | 5052723120 |
| Fax Number: | 5052728060 |
| NPI Enumeration Date: | 01/11/2006 |
| NPI Last Update Date: | 05/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 1482 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |