Healthcare Provider Details

I. General information

NPI: 1144924549
Provider Name (Legal Business Name): GABRIELLE DOUCET M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 PEMBROKE RD
CONCORD NH
03301-5767
US

IV. Provider business mailing address

162 PEMBROKE RD
CONCORD NH
03301-5767
US

V. Phone/Fax

Practice location:
  • Phone: 603-225-4153
  • Fax:
Mailing address:
  • Phone: 603-225-4153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: