Provider Demographics
NPI:1679621445
Name:GABRIEL, KATHY B (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:B
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 RIDGELY AVE
Mailing Address - Street 2:2ND FL.
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1303
Mailing Address - Country:US
Mailing Address - Phone:410-757-1000
Mailing Address - Fax:
Practice Address - Street 1:207 RIDGELY AVE
Practice Address - Street 2:2ND FL.
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1303
Practice Address - Country:US
Practice Address - Phone:410-757-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2012-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02411103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist