Provider Demographics
NPI:1194022780
Name:SLAVIN, GABRIELLE ELANA (MA)
Entity Type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:ELANA
Last Name:SLAVIN
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:PO BOX 4
Mailing Address - Street 2:
Mailing Address - City:MONTAGUE
Mailing Address - State:MA
Mailing Address - Zip Code:01351-0004
Mailing Address - Country:US
Mailing Address - Phone:413-367-2479
Mailing Address - Fax:
Practice Address - Street 1:400 AMITY ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2241
Practice Address - Country:US
Practice Address - Phone:413-549-0095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health