Healthcare Provider Details
I. General information
NPI: 1578355954
Provider Name (Legal Business Name): GABRIELLE MARIE STRAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/20/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
650 E INDIAN SCHOOL RD
PHOENIX AZ
85012-1839
US
IV. Provider business mailing address
500 W CAMELBACK RD UNIT 450
PHOENIX AZ
85013-0013
US
V. Phone/Fax
- Phone: 602-277-5551
- Fax:
- Phone: 952-847-0468
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: