Provider Demographics
NPI:1972260925
Name:BARRE, GABRIELLE (LMT)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:BARRE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16309 E BREWSTER RD APT C224
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-7333
Mailing Address - Country:US
Mailing Address - Phone:504-919-0336
Mailing Address - Fax:
Practice Address - Street 1:16309 E BREWSTER RD APT C224
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-7333
Practice Address - Country:US
Practice Address - Phone:504-919-0336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA97368225700000X
LALA8505225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist