Provider Demographics
NPI:1003182742
Name:BROHNER, GAYLE ANN (MFT)
Entity Type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:ANN
Last Name:BROHNER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13448 ALBERS ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-5320
Mailing Address - Country:US
Mailing Address - Phone:818-780-3580
Mailing Address - Fax:818-780-2762
Practice Address - Street 1:13448 ALBERS ST
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91401-5320
Practice Address - Country:US
Practice Address - Phone:818-780-3580
Practice Address - Fax:818-780-2762
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22086101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health