Provider Demographics
NPI:1902583230
Name:REEVE, GABRIELLA (LSWAIC)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:REEVE
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12109 317TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SULTAN
Mailing Address - State:WA
Mailing Address - Zip Code:98294-4006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12109 317TH AVE SE
Practice Address - Street 2:
Practice Address - City:SULTAN
Practice Address - State:WA
Practice Address - Zip Code:98294-4006
Practice Address - Country:US
Practice Address - Phone:425-551-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical