Provider Demographics
NPI:1982949293
Name:GABRIAU, RONALD JAMES (SW)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:JAMES
Last Name:GABRIAU
Suffix:
Gender:M
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 79TH AVE N
Mailing Address - Street 2:UNIT 132
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-4414
Mailing Address - Country:US
Mailing Address - Phone:727-735-7421
Mailing Address - Fax:
Practice Address - Street 1:3050 1ST AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-1010
Practice Address - Country:US
Practice Address - Phone:727-735-7421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW102331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW10233OtherLICENSED SOCIAL WORKER