Provider Demographics
NPI:1851156962
Name:DRYDEN, GABRIELLE SUZANNE
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:SUZANNE
Last Name:DRYDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13914 5TH PL S
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98168-3540
Mailing Address - Country:US
Mailing Address - Phone:206-437-9305
Mailing Address - Fax:206-333-0553
Practice Address - Street 1:13914 5TH PL S
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98168-3540
Practice Address - Country:US
Practice Address - Phone:206-437-9305
Practice Address - Fax:206-333-0553
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4223168101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor