Healthcare Provider Details

I. General information

NPI: 1619800323
Provider Name (Legal Business Name): GABRIELLE ROSE SOUSA BECK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 GREATHILL DR
BRIDGEWATER MA
02325-1208
US

IV. Provider business mailing address

351 GREATHILL DR
BRIDGEWATER MA
02325-1208
US

V. Phone/Fax

Practice location:
  • Phone: 508-531-1076
  • Fax:
Mailing address:
  • Phone: 508-531-1076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number230528
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: