Provider Demographics
NPI:1548839889
Name:HOUSTON, GABRIELLE (BCBA)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 TOWNE PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-9369
Mailing Address - Country:US
Mailing Address - Phone:912-429-7931
Mailing Address - Fax:
Practice Address - Street 1:806 TOWNE PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-9369
Practice Address - Country:US
Practice Address - Phone:912-429-7931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-21-172372106S00000X
GA1-25-78799103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician