Provider Demographics
NPI:1356961072
Name:GABLE, PAULA R CANNON (LMFT, LAC)
Entity type:Individual
Prefix:DR
First Name:PAULA R
Middle Name:CANNON
Last Name:GABLE
Suffix:
Gender:F
Credentials:LMFT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3027 KNOLLS END DR UNIT 5
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5827
Mailing Address - Country:US
Mailing Address - Phone:303-357-9743
Mailing Address - Fax:
Practice Address - Street 1:300 E HORSETOOTH RD STE 200
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3154
Practice Address - Country:US
Practice Address - Phone:303-357-9743
Practice Address - Fax:303-985-7882
Is Sole Proprietor?:No
Enumeration Date:2020-04-22
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0001960106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist