Healthcare Provider Details

I. General information

NPI: 1942620646
Provider Name (Legal Business Name): JOY GABRIELLI PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOY POTTER

II. Dates (important events)

Enumeration Date: 04/21/2014
Last Update Date: 04/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 SW ARCHER RD G-901
GAINESVILLE FL
32610-7825
US

IV. Provider business mailing address

PO BOX 100256
GAINESVILLE FL
32610-0256
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-8248
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number10367
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY10367
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: