Provider Demographics
NPI:1568115251
Name:GUERRERO, GABRIELLA ESMERALDA (BA)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:ESMERALDA
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 ABBOTT ST
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-1502
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2626 SAINT JOE CENTER RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-5042
Practice Address - Country:US
Practice Address - Phone:260-497-0328
Practice Address - Fax:260-497-0904
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No175T00000XOther Service ProvidersPeer Specialist