Provider Demographics
NPI:1932361391
Name:GABRIEL, RENITA CHERISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:RENITA
Middle Name:CHERISE
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8003 RIVER PARK RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-3343
Mailing Address - Country:US
Mailing Address - Phone:301-412-7153
Mailing Address - Fax:
Practice Address - Street 1:1641 MARYLAND RT 3 N STE 201
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2464
Practice Address - Country:US
Practice Address - Phone:240-709-3029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04624103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical