Provider Demographics
NPI:1457094054
Name:GIBBS, GABRIELLA MONIQUE (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLA
Middle Name:MONIQUE
Last Name:GIBBS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MISS
Other - First Name:GABRIELLA
Other - Middle Name:MONIQUE
Other - Last Name:MORELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MORELAND
Mailing Address - Street 1:42 S SUNSET RD
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85119-7823
Mailing Address - Country:US
Mailing Address - Phone:480-283-5153
Mailing Address - Fax:
Practice Address - Street 1:42 S SUNSET RD
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85119-7823
Practice Address - Country:US
Practice Address - Phone:480-283-5153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-22-58545103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst