Provider Demographics
NPI:1851626907
Name:GABRIELE, SUZANNE MIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:MIA
Last Name:GABRIELE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2813
Mailing Address - Country:US
Mailing Address - Phone:914-419-2345
Mailing Address - Fax:845-279-1373
Practice Address - Street 1:49 SMITH AVE
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2813
Practice Address - Country:US
Practice Address - Phone:914-419-2345
Practice Address - Fax:845-279-1373
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17746103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling