Provider Demographics
NPI:1255676334
Name:MOLINA, GABRIELLE N
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:N
Last Name:MOLINA
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 1:1924 W STEVENS ST STE 202
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-7043
Mailing Address - Country:US
Mailing Address - Phone:406-595-3746
Mailing Address - Fax:406-578-1363
Practice Address - Street 1:1924 W STEVENS ST STE 202
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-7043
Practice Address - Country:US
Practice Address - Phone:406-595-3746
Practice Address - Fax:406-578-1363
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical