Provider Demographics
NPI:1316421035
Name:DROUILLARD-MOSER, GABRIELLA (MA, MA,)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:DROUILLARD-MOSER
Suffix:
Gender:F
Credentials:MA, MA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 CLEMMONS RD # 1494
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-9998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:149 YADKIN VALLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:ADVANCE
Practice Address - State:NC
Practice Address - Zip Code:27006-8783
Practice Address - Country:US
Practice Address - Phone:336-941-7544
Practice Address - Fax:336-551-8961
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YA0400X
NCLCMHC15693101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)