Provider Demographics
NPI:1518147677
Name:AYALA, GABRIELLE CELESTE (LCSW)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:CELESTE
Last Name:AYALA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:ANTONIA
Other - Last Name:AYALA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3009 N A ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2350
Mailing Address - Country:US
Mailing Address - Phone:813-277-4559
Mailing Address - Fax:813-673-8946
Practice Address - Street 1:3009 N A ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2350
Practice Address - Country:US
Practice Address - Phone:813-277-4559
Practice Address - Fax:813-673-8946
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLORIDA LCSW 57151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical