Provider Demographics
NPI:1528225257
Name:PARRA, GABRIEL J (LMSW)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:J
Last Name:PARRA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8285 LAKE CREST DR
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-6754
Mailing Address - Country:US
Mailing Address - Phone:734-340-6353
Mailing Address - Fax:
Practice Address - Street 1:8285 LAKE CREST DR
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-6754
Practice Address - Country:US
Practice Address - Phone:734-340-6353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010888291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical