Provider Demographics
NPI:1659979441
Name:HARTMAN, GABRIELLE BARILLAS (LMFT)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:BARILLAS
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 BOYSON RD STE A
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-1270
Mailing Address - Country:US
Mailing Address - Phone:319-250-1267
Mailing Address - Fax:319-200-4456
Practice Address - Street 1:1811 BOYSON RD STE A
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-1270
Practice Address - Country:US
Practice Address - Phone:319-250-1267
Practice Address - Fax:319-200-4456
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087224101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor