Provider Demographics
NPI:1265392583
Name:GABRIEL, MOLLY R (CHW)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:R
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 MUNN ST
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:MI
Mailing Address - Zip Code:49421-9713
Mailing Address - Country:US
Mailing Address - Phone:231-327-1453
Mailing Address - Fax:
Practice Address - Street 1:316 MUNN ST
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:MI
Practice Address - Zip Code:49421-9713
Practice Address - Country:US
Practice Address - Phone:231-327-1453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker