Provider Demographics
NPI:1760108054
Name:GUZMAN, GABRIELLA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:GABRIELLA
Middle Name:
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 LOFT DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08836-2261
Mailing Address - Country:US
Mailing Address - Phone:908-672-0736
Mailing Address - Fax:
Practice Address - Street 1:52 LOFT DR
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08836-2261
Practice Address - Country:US
Practice Address - Phone:908-672-0736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI006677400103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical