Individual
MR. MARK S GABRIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
275 WOODCHCUK HILL RD, GRAFTON, VT 05146-0223
(802) 843-2322
Mailing address
PO BOX 223, GRAFTON, VT 05146-0223
(802) 843-2322
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0000305
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0093640
MHN SERVICES
VT
05
—
0VN0167
—
VT
01
—
18285
BCBS
VT
Enumeration date
12/26/2006
Last updated
07/09/2007
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