Provider Demographics
NPI:1225679301
Name:LOUISSAINT, GABRIELLE
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:
Last Name:LOUISSAINT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5803 63RD PL
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-2516
Mailing Address - Country:US
Mailing Address - Phone:240-423-9298
Mailing Address - Fax:
Practice Address - Street 1:5803 63RD PL
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-2516
Practice Address - Country:US
Practice Address - Phone:240-423-9298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician