Provider Demographics
NPI:1760435697
Name:WAITS, GABRIELE MARIA (MFT)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELE
Middle Name:MARIA
Last Name:WAITS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 E FLAMINGO RD
Mailing Address - Street 2:STE. B
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5269
Mailing Address - Country:US
Mailing Address - Phone:702-204-8105
Mailing Address - Fax:702-892-3526
Practice Address - Street 1:2840 E FLAMINGO RD
Practice Address - Street 2:STE. B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5269
Practice Address - Country:US
Practice Address - Phone:702-204-8105
Practice Address - Fax:702-892-3526
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0966106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist