Provider Demographics
NPI:1639771553
Name:WOODWARD, GABRIELLE LYNN (MA)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:LYNN
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 N 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-2013
Mailing Address - Country:US
Mailing Address - Phone:856-873-4607
Mailing Address - Fax:
Practice Address - Street 1:127 E CHESTNUT ST FL 3
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2651
Practice Address - Country:US
Practice Address - Phone:484-887-8385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health