Provider Demographics
NPI:1033628375
Name:GABRIEL, DEBBIE (BCABA)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23360 BRIDLE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-5511
Mailing Address - Country:US
Mailing Address - Phone:843-283-2783
Mailing Address - Fax:
Practice Address - Street 1:23360 BRIDLE VIEW DR
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-5511
Practice Address - Country:US
Practice Address - Phone:843-283-2783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0-02-0458103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0-02-0458OtherBACB