Provider Demographics
NPI:1124696893
Name:PRIETO, GABRIELA (BCABA)
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:PRIETO
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4778 OVERTON RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35210-3803
Mailing Address - Country:US
Mailing Address - Phone:205-957-0294
Mailing Address - Fax:205-957-0298
Practice Address - Street 1:2305 ARLINGTON AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-3803
Practice Address - Country:US
Practice Address - Phone:205-957-2242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2024-070OtherALABAMA STATE LICENSING BOARD