Provider Demographics
NPI:1538602826
Name:CIARALLO, GABRIELLE (MA, BCBA)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:CIARALLO
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 GARDEN ST
Mailing Address - Street 2:APT 4A
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-3738
Mailing Address - Country:US
Mailing Address - Phone:551-427-3419
Mailing Address - Fax:
Practice Address - Street 1:127 GARDEN ST
Practice Address - Street 2:APT 4A
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-3738
Practice Address - Country:US
Practice Address - Phone:551-427-3419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-18
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-16-22831103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst