Provider Demographics
NPI:1891819082
Name:ADAMS, GABRIELLE (MS, SLPD)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MS, SLPD
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:
Other - Last Name:HALIBURTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHESILHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:08089-1644
Mailing Address - Country:US
Mailing Address - Phone:609-257-7477
Mailing Address - Fax:
Practice Address - Street 1:115 SUDBROOK LN STE A
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-4184
Practice Address - Country:US
Practice Address - Phone:410-358-1997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2022-12-27
Deactivation Date:2022-12-12
Deactivation Code:
Reactivation Date:2022-12-27
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00539700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist