Provider Demographics
NPI:1588452981
Name:QUINTANA, GABRIELLA LOUISE
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:LOUISE
Last Name:QUINTANA
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 1:13201 HIGHLANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44135-1616
Mailing Address - Country:US
Mailing Address - Phone:216-233-0986
Mailing Address - Fax:216-233-0986
Practice Address - Street 1:13201 HIGHLANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44135-1616
Practice Address - Country:US
Practice Address - Phone:216-233-0986
Practice Address - Fax:216-233-0986
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1820VJ59176300385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child