Provider Demographics
NPI:1508805763
Name:GABRIELE, ROSARIA V (PHD)
Entity Type:Individual
Prefix:
First Name:ROSARIA
Middle Name:V
Last Name:GABRIELE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3014 SMOKETOWN RD
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-6540
Mailing Address - Country:US
Mailing Address - Phone:570-524-8476
Mailing Address - Fax:
Practice Address - Street 1:3014 SMOKETOWN RD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-6540
Practice Address - Country:US
Practice Address - Phone:570-524-8476
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005258L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling