Provider Demographics
NPI:1659089522
Name:CUADRA, GABRIELLE (MS)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:CUADRA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1961 SABAL PALM DR
Mailing Address - Street 2:
Mailing Address - City:MERCEDES
Mailing Address - State:TX
Mailing Address - Zip Code:78570-9342
Mailing Address - Country:US
Mailing Address - Phone:956-650-1906
Mailing Address - Fax:
Practice Address - Street 1:1001 E TYLER AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7135
Practice Address - Country:US
Practice Address - Phone:956-423-1194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX88991101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health