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General NPI Number Information
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NPI Number | 1669147732
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Entity Type | Individual
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Provider Name | GABRIELA BROCKETT PHD, LCMFT
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Gender | Female
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 11 COURT ST STE 210
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City | EXETER
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State | NH
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Zip | 03833-2745
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Country | US
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Telephone | 603-242-2296
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Fax |
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Provider Business Mailing Address
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Address Line | 5654 SHIELDS DR
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City | BETHESDA
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State | MD
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Zip | 20817-3574
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LCM944
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 330
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT200001342
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License Number State | DC
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