Provider Demographics
NPI:1033940721
Name:FIORE, GABRIELLA (LSW)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:FIORE
Suffix:
Gender:X
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 DICKINSON ST # 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-4817
Mailing Address - Country:US
Mailing Address - Phone:732-998-3620
Mailing Address - Fax:
Practice Address - Street 1:133 COULTER AVE STE 1
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2416
Practice Address - Country:US
Practice Address - Phone:215-275-8710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1413181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical