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General NPI Number Information
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NPI Number | 1073477261
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Entity Type | Individual
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Provider Name | GABRIELLE WAVERLY GAULDIN MS, LCGC
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Gender | Female
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 601 E ROLLINS ST STE 125
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City | ORLANDO
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State | FL
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Zip | 32803-1248
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Country | US
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Telephone | 407-646-7165
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Fax |
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Provider Business Mailing Address
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Address Line | 4915 WILLOW WINDS WAY APT 101
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City | SANFORD
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State | FL
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Zip | 32771-8550
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170300000X
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Taxonomy Name | Genetic Counselor (M.S.)
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License Number | GC879
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License Number State | FL
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