Provider Demographics
NPI:1730826710
Name:TESTA, GABRIELLE MARIA
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:MARIA
Last Name:TESTA
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 1:76 WESTBURY PARK RD # 306E
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06795-2779
Mailing Address - Country:US
Mailing Address - Phone:860-294-1543
Mailing Address - Fax:
Practice Address - Street 1:76 WESTBURY PARK RD # 306E
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-2779
Practice Address - Country:US
Practice Address - Phone:860-294-1543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst