MEDICARE: GABRIELA NICOLE SUITOR

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	101YP2500X	Professional Counselor	92110	TX

General Provider Information

NPI Number	:	1598393423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELA NICOLE SUITOR

Provider Business Mailing Address
First Line	:	104 LONG BOW RD
Second Line	:
City	:	SHAVANO PARK
State	:	TX
Zip	:	78231-1209
Country	:	US
Telephone Number	:	855-782-7822
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 LONG BOW RD
Second Line	:
City	:	SHAVANO PARK
State	:	TX
Zip	:	78231-1209
Country	:	US
Telephone Number	:	210-887-3489
Fax Number	:

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

Provider Enumeration Date	:	03/27/2020
Last Update Date	:	10/20/2025

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Directions to “ GABRIELA NICOLE SUITOR ” Practice Location

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