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General NPI Number Information
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NPI Number | 1821754185
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Entity Type | Individual
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Provider Name | GABRIELLE DE LA FLOR LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/11/2021
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 9420 FAIRFAX BLVD SUITE 4
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City | FAIRFAX
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State | VA
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Zip | 22031
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Country | US
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Telephone | 443-393-3657
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Fax |
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Provider Business Mailing Address
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Address Line | 7511 DEVRIES DR
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City | LORTON
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State | VA
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Zip | 22079-1605
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Country | US
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Telephone | 757-651-2376
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904013348
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License Number State | VA
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