Provider Demographics
NPI:1063019255
Name:SIMOES, GABRIELLE N (MA)
Entity Type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:N
Last Name:SIMOES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14947 CENTREVILLE ST
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-2931
Mailing Address - Country:US
Mailing Address - Phone:347-556-2495
Mailing Address - Fax:
Practice Address - Street 1:14947 CENTREVILLE ST
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417-2931
Practice Address - Country:US
Practice Address - Phone:347-556-2495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist