Provider Demographics
NPI:1457550188
Name:LAWHON, GABRIELLE DAWN (PHD)
Entity Type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:DAWN
Last Name:LAWHON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 GREGORY ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-1844
Mailing Address - Country:US
Mailing Address - Phone:415-652-4310
Mailing Address - Fax:
Practice Address - Street 1:2905 GREGORY ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-1844
Practice Address - Country:US
Practice Address - Phone:415-652-4310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA21968103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health