Provider Demographics
NPI:1336224328
Name:GABELYA, ANNE (MS)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:
Last Name:GABELYA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:GABELYA
Other - Last Name:MIRANIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:720 MOOREFIELD PARK DRIVE
Mailing Address - Street 2:#202
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23236
Mailing Address - Country:US
Mailing Address - Phone:804-272-7611
Mailing Address - Fax:804-560-5574
Practice Address - Street 1:720 MOOREFIELD PARK DRIVE
Practice Address - Street 2:#202
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23236
Practice Address - Country:US
Practice Address - Phone:804-272-7611
Practice Address - Fax:804-560-5574
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000953101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5404860Medicaid