Healthcare Provider Details

I. General information

NPI: 1437502598
Provider Name (Legal Business Name): GABRIELLA SILVEIRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2016
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12725 W INDIAN SCHOOL RD
AVONDALE AZ
85392-9520
US

IV. Provider business mailing address

12725 W INDIAN SCHOOL RD
AVONDALE AZ
85392-9520
US

V. Phone/Fax

Practice location:
  • Phone: 623-303-4735
  • Fax: 602-926-0352
Mailing address:
  • Phone: 623-303-4735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBEH-002048
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: