Provider Demographics
NPI:1881177129
Name:SUNDERLAND, GABRIELLE MAURA (LCMFT)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:MAURA
Last Name:SUNDERLAND
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:GARDEN PLAIN
Mailing Address - State:KS
Mailing Address - Zip Code:67050-0246
Mailing Address - Country:US
Mailing Address - Phone:316-302-5464
Mailing Address - Fax:
Practice Address - Street 1:358 N MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-1509
Practice Address - Country:US
Practice Address - Phone:316-351-7644
Practice Address - Fax:316-351-7689
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist