Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor |
NPI | 1003281510 |
---|---|
Provider Name | Gabrielle Gatewood |
First Address | Fresno, CA 93711-0268 |
Second Address | Fresno, CA 93720-2342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2015 |
Last Update Date | 26/10/2021 |