Provider Demographics
NPI:1689979700
Name:GABRIEL, RONALD JAMES (OT)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:JAMES
Last Name:GABRIEL
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:RONALD
Other - Middle Name:
Other - Last Name:GABRIEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:2007 SIMCA CT
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-4012
Mailing Address - Country:US
Mailing Address - Phone:919-608-9847
Mailing Address - Fax:
Practice Address - Street 1:2007 SIMCA CT
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-4012
Practice Address - Country:US
Practice Address - Phone:919-608-9847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3563225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist