Provider Demographics
NPI:1508497843
Name:BATE-MATCHETT, GABRIELLE (BCBA)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:BATE-MATCHETT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5411 PEDEN POINT RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-4307
Mailing Address - Country:US
Mailing Address - Phone:515-473-4192
Mailing Address - Fax:
Practice Address - Street 1:500 MILITARY CUTOFF RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-9737
Practice Address - Country:US
Practice Address - Phone:910-524-2634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
NC1-22-59637103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician