Provider Demographics
NPI:1124903323
Name:MADRAZO, GIA MARIE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:GIA
Middle Name:MARIE
Last Name:MADRAZO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 PLEASANT VIEW RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-3477
Mailing Address - Country:US
Mailing Address - Phone:908-456-2411
Mailing Address - Fax:908-456-2411
Practice Address - Street 1:600 AUTEN RD
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-5572
Practice Address - Country:US
Practice Address - Phone:374-292-2643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01323100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist