Provider Demographics
NPI:1952142580
Name:DAVILA, GABRIELLA CYNTHIA (LSW)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:CYNTHIA
Last Name:DAVILA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1654 EVERETT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44514-1018
Mailing Address - Country:US
Mailing Address - Phone:724-747-5187
Mailing Address - Fax:
Practice Address - Street 1:1771 MARKET ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44507-1135
Practice Address - Country:US
Practice Address - Phone:330-744-5143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2410918101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor