Healthcare Provider Details

I. General information

NPI: 1922914456
Provider Name (Legal Business Name): GABRIA LEIGH ANNE HUBBARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2028 ROLLING BROOK DR NE
CLEVELAND TN
37323-5912
US

IV. Provider business mailing address

2028 ROLLING BROOK DR NE
CLEVELAND TN
37323-5912
US

V. Phone/Fax

Practice location:
  • Phone: 423-790-6994
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: