Healthcare Provider Details

I. General information

NPI: 1194615203
Provider Name (Legal Business Name): GABRIELLE HINGERTY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4551 JOHN TYLER HWY STE 201
WILLIAMSBURG VA
23185-2453
US

IV. Provider business mailing address

4551 JOHN TYLER HWY STE 201
WILLIAMSBURG VA
23185-2453
US

V. Phone/Fax

Practice location:
  • Phone: 757-936-2061
  • Fax:
Mailing address:
  • Phone: 757-936-2061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0134000697
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: