Provider Demographics
NPI:1558658310
Name:KLEIN-FOWLER, GABRIELLE EVE (MED, NCC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:EVE
Last Name:KLEIN-FOWLER
Suffix:
Gender:F
Credentials:MED, NCC, LPC
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:EVE
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED
Mailing Address - Street 1:231 N SPRING ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-2231
Mailing Address - Country:US
Mailing Address - Phone:336-899-8800
Mailing Address - Fax:
Practice Address - Street 1:231 N SPRING ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2231
Practice Address - Country:US
Practice Address - Phone:336-899-8800
Practice Address - Fax:336-899-8811
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000521101YM0800X
VA0701004891101YP2500X
NC9552101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional