Provider Demographics
NPI:1457149015
Name:VAILLANCOURT, GABRIELA
Entity type:Individual
Prefix:
First Name:GABRIELA
Middle Name:
Last Name:VAILLANCOURT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 KINGS HIGHWAY
Mailing Address - Street 2:THE STEPPING STONE GROUP
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-0274
Mailing Address - Country:US
Mailing Address - Phone:207-952-3819
Mailing Address - Fax:
Practice Address - Street 1:500 KINGS HIGHWAY
Practice Address - Street 2:THE STEPPING STONE GROUP
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-0274
Practice Address - Country:US
Practice Address - Phone:207-952-3819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician