Provider Demographics
NPI:1013514843
Name:YESHUA, GABRIELA LIAT (MSW)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:LIAT
Last Name:YESHUA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 LOGAN ST # N404
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-7361
Mailing Address - Country:US
Mailing Address - Phone:786-547-1392
Mailing Address - Fax:
Practice Address - Street 1:34 GIFFORD ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02744-2610
Practice Address - Country:US
Practice Address - Phone:786-547-1392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)