Provider Demographics
NPI:1003687237
Name:MARSON-GAISER, GABRIELLE (LPC)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:MARSON-GAISER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2990 E NORTHERN AVE STE A100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-4834
Mailing Address - Country:US
Mailing Address - Phone:602-525-6049
Mailing Address - Fax:
Practice Address - Street 1:2990 E NORTHERN AVE STE A100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-4834
Practice Address - Country:US
Practice Address - Phone:602-525-6049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-22664101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional