Provider Demographics
NPI:1548957301
Name:LANCASTER, GABRIEL JAMES JOSHUA
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:JAMES JOSHUA
Last Name:LANCASTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 RIDGECREST CT APT 1416
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-7561
Mailing Address - Country:US
Mailing Address - Phone:405-640-9814
Mailing Address - Fax:
Practice Address - Street 1:2801 WASHINGTON DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-1028
Practice Address - Country:US
Practice Address - Phone:405-561-5512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician