Provider Demographics
NPI:1558649889
Name:MANCINI, GABRIELA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:M
Last Name:MANCINI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 S STATE ROAD 7
Mailing Address - Street 2:# 104-449
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4385
Mailing Address - Country:US
Mailing Address - Phone:954-553-8182
Mailing Address - Fax:
Practice Address - Street 1:125 S STATE ROAD 7
Practice Address - Street 2:# 104-449
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4385
Practice Address - Country:US
Practice Address - Phone:561-203-5867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 8317103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical