Provider Demographics
NPI:1275326712
Name:BEAUDOIN, GABRIELLE
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:BEAUDOIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3025 COAL MINE AVE APT 5C
Mailing Address - Street 2:
Mailing Address - City:RIFLE
Mailing Address - State:CO
Mailing Address - Zip Code:81650-3922
Mailing Address - Country:US
Mailing Address - Phone:207-500-8146
Mailing Address - Fax:
Practice Address - Street 1:2001 N HORSESHOE TRL
Practice Address - Street 2:
Practice Address - City:SILT
Practice Address - State:CO
Practice Address - Zip Code:81652-9832
Practice Address - Country:US
Practice Address - Phone:970-876-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker