Individual provider · NPI-1

Gabrielle Nicole Axson, DPT

Physical Therapist, Pediatrics · Charleston, SC

NPI number1407796493
StatusActive
Last updated in NPPESMar 30, 2026

Details

NPI
1407796493
Entity type
Individual (NPI-1)
Name
Gabrielle Nicole Axson
Credential
DPT
Sex
Female
Sole proprietor
No
Enumeration date
Mar 30, 2026
Certification date
Mar 28, 2026
Last updated
Mar 30, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2251P0200X Physical Therapist, Pediatrics–SCYes

Practice location

2387 Lantern St
Charleston, SC 29414-4850

Phone 317-750-9879 · Fax 843-620-0722

Mailing address

2387 Lantern St
Charleston, SC 29414-4850

Phone 317-750-9879 · Fax 843-620-0722

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