Individual
GABRIELLE J DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC, NCC
Contact information
Practice address
166 MAIN ST, MATAWAN, NJ 07747
(732) 290-9040
Mailing address
166 MAIN ST, MATAWAN, NJ 07747-3104
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
37AC00400000
NJ
Other
Enumeration date
01/28/2018
Last updated
06/18/2018
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