Provider Demographics
NPI:1629844683
Name:BARDGETTE, GABRIELA ALICIA (LPC-ASSOCIATE)
Entity Type:Individual
Prefix:MS
First Name:GABRIELA
Middle Name:ALICIA
Last Name:BARDGETTE
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 171372
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-8372
Mailing Address - Country:US
Mailing Address - Phone:210-846-4169
Mailing Address - Fax:
Practice Address - Street 1:250 E BASSE RD STE 206
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-8409
Practice Address - Country:US
Practice Address - Phone:210-846-4169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90623101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health