Provider Demographics
NPI:1164889416
Name:DR GABBERT CLINICAL PSYCHOLOGIST PLLC
Entity Type:Organization
Organization Name:DR GABBERT CLINICAL PSYCHOLOGIST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:GABBERT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:701-227-7579
Mailing Address - Street 1:806 HIGHWAY 8 N
Mailing Address - Street 2:
Mailing Address - City:HETTINGER
Mailing Address - State:ND
Mailing Address - Zip Code:58639-8825
Mailing Address - Country:US
Mailing Address - Phone:701-567-6631
Mailing Address - Fax:
Practice Address - Street 1:806 HIGHWAY 8 N
Practice Address - Street 2:
Practice Address - City:HETTINGER
Practice Address - State:ND
Practice Address - Zip Code:58639-8825
Practice Address - Country:US
Practice Address - Phone:701-567-6631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-18
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty