Provider Demographics
NPI:1619172418
Name:LUKE, GABRIELLE (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:LUKE
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8559 STILLWATER CIR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-7125
Mailing Address - Country:US
Mailing Address - Phone:214-349-4692
Mailing Address - Fax:
Practice Address - Street 1:3740 NORTH JOSEY LANE SUITE 125
Practice Address - Street 2:HEARING HAVEN LLC
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2474
Practice Address - Country:US
Practice Address - Phone:972-394-4370
Practice Address - Fax:972-394-2691
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50173231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter