Healthcare Provider Details

I. General information

NPI: 1861299141
Provider Name (Legal Business Name): GABRIELLE HOANG MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2025
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S 20TH ST
PHILADELPHIA PA
19103-4486
US

IV. Provider business mailing address

47 TOWER AVE
EGG HARBOR TOWNSHIP NJ
08234-4865
US

V. Phone/Fax

Practice location:
  • Phone: 609-594-7173
  • Fax:
Mailing address:
  • Phone: 609-594-7173
  • 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:
Title or Position:
Credential:
Phone: