Provider Demographics
NPI:1639355308
Name:MILLER, GABRIELA (LMFT, IMH-E(III))
Entity Type:Individual
Prefix:MRS
First Name:GABRIELA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:LMFT, IMH-E(III)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 MENAUL BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-1834
Mailing Address - Country:US
Mailing Address - Phone:505-206-2167
Mailing Address - Fax:
Practice Address - Street 1:2400 MENAUL BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1834
Practice Address - Country:US
Practice Address - Phone:505-206-2167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-12
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0131111106H00000X
NMT-0109721106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist