MEDICARE: GABRIELLE HENRINE FERIOLI LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker		OK

General Provider Information

NPI Number	:	1043978158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLE HENRINE FERIOLI LMSW

Provider Business Mailing Address
First Line	:	1020 W SILVER MEADOW DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73110-1339
Country	:	US
Telephone Number	:	314-703-6170
Fax Number	:

Provider Business Practice Location Address
First Line	:	3814 N SANTA FE AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-8509
Country	:	US
Telephone Number	:	405-618-2205
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2021
Last Update Date	:	12/06/2021

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