Healthcare Provider Details

I. General information

NPI: 1528542826
Provider Name (Legal Business Name): GABRIEL LUKE ARMSHAW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 DILIGENCE DR STE 102
NEWPORT NEWS VA
23606-4211
US

IV. Provider business mailing address

825 DILIGENCE DR STE 102
NEWPORT NEWS VA
23606-4211
US

V. Phone/Fax

Practice location:
  • Phone: 757-244-9525
  • Fax: 903-200-1505
Mailing address:
  • Phone: 757-244-9525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133005446
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: