Provider Demographics
NPI:1053644690
Name:HURTUBISE, GABRIELLE MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:MARIE
Last Name:HURTUBISE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4 NOB HL
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-5544
Mailing Address - Country:US
Mailing Address - Phone:917-836-0639
Mailing Address - Fax:845-462-0918
Practice Address - Street 1:4 NOB HL
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-5544
Practice Address - Country:US
Practice Address - Phone:917-836-0639
Practice Address - Fax:845-462-0918
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005812-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist