Provider Demographics
NPI:1750147286
Name:KING, GABRIELLE MCVAY (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:MCVAY
Last Name:KING
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17900 N HAYDEN RD APT 3018
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6730
Mailing Address - Country:US
Mailing Address - Phone:480-299-2270
Mailing Address - Fax:
Practice Address - Street 1:17900 N HAYDEN RD APT 3018
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6730
Practice Address - Country:US
Practice Address - Phone:480-299-2270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ719159103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst