Provider Demographics
NPI:1770343972
Name:IANNITTI, GABRIELA ANTOINETTE
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:ANTOINETTE
Last Name:IANNITTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E CURTIS ST STE A
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-2620
Mailing Address - Country:US
Mailing Address - Phone:864-376-7911
Mailing Address - Fax:
Practice Address - Street 1:120 E CURTIS ST STE A
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-2620
Practice Address - Country:US
Practice Address - Phone:864-376-7911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistGroup - Single Specialty