Provider Demographics
NPI:1003522467
Name:BROWN, GABRIELLE (MT 06338)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MT 06338
Other - Prefix:MISS
Other - First Name:GABRIELLE
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:GABRIELLE BROWN
Mailing Address - Street 1:10470 E SAUCITO CANYON PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-3474
Mailing Address - Country:US
Mailing Address - Phone:520-232-4680
Mailing Address - Fax:
Practice Address - Street 1:10470 E SAUCITO CANYON PL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85748-3474
Practice Address - Country:US
Practice Address - Phone:520-232-4680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-06338225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist