| Doctor Name: | DR. GINA M MOG |
| NPI Number: | 1891805016 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D |
| License Number: | 35SI00364100 |
| Business Practice Address: | 2235 Ocean Heights Ave Egg Harbor Twp, NJ - 082345933 |
| Business Phone Number: | 6099265522 |
| Business Fax Number: | 6099265581 |
| Mailing Address: | Po Box 50, SOMERS POINT |
| State: | NJ |
| Postal Code: | 082440050 |
| Phone Number: | 8567653192 |
| Fax Number: | |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 35SI00364100 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |