Healthcare Provider Details

I. General information

NPI: 1265374300
Provider Name (Legal Business Name): THE GAB LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 COURT ST
REDDING CA
96001-1635
US

IV. Provider business mailing address

1308 COURT ST
REDDING CA
96001-1635
US

V. Phone/Fax

Practice location:
  • Phone: 530-605-0050
  • Fax:
Mailing address:
  • Phone: 530-605-0050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: CAMILLE ANN COULTER
Title or Position: PSYCHOTHERAPIST
Credential: LMFT
Phone: 530-953-6000