MEDICARE: NICOLE GABBERT BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	850584	NC

General Provider Information

NPI Number	:	1881547131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE GABBERT BCBA

Provider Business Mailing Address
First Line	:	PO BOX 10448
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85130-0059
Country	:	US
Telephone Number	:	617-596-9390
Fax Number	:	919-410-8979

Provider Business Practice Location Address
First Line	:	3911 WRIGHTSVILLE AVE
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28403-6225
Country	:	US
Telephone Number	:	617-596-9390
Fax Number	:	919-410-8979

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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