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NPI 1669035465

NPI 1669035465 : GABRIELLE MURRAY : CODY, WY

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General NPI Number Information
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    NPI Number           |    1669035465
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    Entity Type          |    Individual 
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    Provider Name        |    GABRIELLE MURRAY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/17/2019
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    Last Update Date     |    07/16/2019
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Provider Practice Location Address
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    Address Line         |    11 COTTONTAIL LN UNIT B 
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    City                 |    CODY
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    State                |    WY
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    Zip                  |    82414-8339
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    Country              |    US
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    Telephone            |    917-620-7799
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11 COTTONTAIL LN UNIT B 
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    City                 |    CODY
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    State                |    WY
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    Zip                  |    82414-8339
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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        |    372600000X
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    Taxonomy Name        |    Adult Companion
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    373H00000X
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    Taxonomy Name        |    Day Training/Habilitation Specialist
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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