Jeanne Marisa Gabriele, PH.D.
Individual provider Active NPI Clinical Psychologist · Jackson, MS
NPI 1104134519 · NPPES record last updated Sep 20, 2010
Key facts
- NPI
- 1104134519
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 50864 (MS)
- Practice address
- 1500 E Woodrow Wilson Ave
Mental Health (11M)
Jackson, MS 39216-5116 - Phone
- (601) 362-4471
- NPI assigned
- Sep 20, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 50864 | MS | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 50864 | MS | Yes |
Addresses
Primary practice location
1500 E Woodrow Wilson Ave
Mental Health (11M)
Jackson, MS 39216-5116
Mailing address
1500 E Woodrow Wilson Ave
Mental Health (11M)
Jackson, MS 39216-5116
Phone (601) 362-4471
Other providers in Jackson, MS
- G Eli Howell MD PLLC
- G. V. Sonny Montgomery VA Medical Center
- G.V. Montgomery VA Medical Center
- G.V. Sonny Montgomery Medical Center
- Ricky L Gable
- Dora Ann Gaddis
- Menarvia Nixon Gaddis
- William Gadow
- Kimberly Gaines
- Misty Gaines
All providers in Jackson, MS · Clinical Psychologist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.