Healthcare Provider Details

I. General information

NPI: 1164169025
Provider Name (Legal Business Name): MARIA GABRIELA WILFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA GABRIELA LOPEZ-LOAISIGIA

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US ARMY MEDICAL ACTIVITY-BAVARIA UNIT 28038 ATTN: MCEU-BAV-CRE
APO AE
09112-8038
US

IV. Provider business mailing address

PSC 480 BOX 666
APO AE
09128-0007
US

V. Phone/Fax

Practice location:
  • Phone: 496-371-9464
  • Fax:
Mailing address:
  • Phone: 405-615-2906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-76945
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: