Provider Demographics
NPI:1114224862
Name:GABRIELE, ROSLYN TERESE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ROSLYN
Middle Name:TERESE
Last Name:GABRIELE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 SETTLERS RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-3704
Mailing Address - Country:US
Mailing Address - Phone:616-796-9595
Mailing Address - Fax:
Practice Address - Street 1:355 SETTLERS RD
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-3704
Practice Address - Country:US
Practice Address - Phone:616-796-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI18058261041C0700X
MI68010920521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical