Healthcare Provider Details

I. General information

NPI: 1205498805
Provider Name (Legal Business Name): GABRIELLE LAWRENCE PHD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2019
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10245 E VIA LINDA BLVD. STE. 105
SCOTTSDALE AZ
85258-5316
US

IV. Provider business mailing address

10245 E VIA LINDA BLVD. STE. 105
SCOTTSDALE AZ
85258-5316
US

V. Phone/Fax

Practice location:
  • Phone: 480-607-5030
  • Fax: 480-948-9054
Mailing address:
  • Phone: 480-607-5030
  • Fax: 480-612-0213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. GABRIELLE B LAWRENCE
Title or Position: PRESIDENT
Credential: PHD
Phone: 480-607-5030