Provider Demographics
NPI:1972265049
Name:MARSHALL, GABRIELLE KATE (LSW)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:KATE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 SHELBOURNE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-9607
Mailing Address - Country:US
Mailing Address - Phone:494-706-9465
Mailing Address - Fax:
Practice Address - Street 1:2913 WINDMILL RD STE 1
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-1669
Practice Address - Country:US
Practice Address - Phone:494-706-9465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW136336101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor