Provider Demographics
NPI:1740562172
Name:HERNANDEZ DE ALBA, GABRIELA SAILE (MSW-I)
Entity Type:Individual
Prefix:MISS
First Name:GABRIELA
Middle Name:SAILE
Last Name:HERNANDEZ DE ALBA
Suffix:
Gender:F
Credentials:MSW-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 BUCKLEY LN
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-5031
Mailing Address - Country:US
Mailing Address - Phone:801-373-6562
Mailing Address - Fax:801-375-9225
Practice Address - Street 1:1726 BUCKLEY LN
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-5031
Practice Address - Country:US
Practice Address - Phone:801-373-6562
Practice Address - Fax:801-375-9225
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT870255206390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program