Provider Demographics
NPI:1003908211
Name:IHLE, GAIL MAUREEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:MAUREEN
Last Name:IHLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 J ST
Mailing Address - Street 2:SUITE 403
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-2900
Mailing Address - Country:US
Mailing Address - Phone:402-435-1313
Mailing Address - Fax:402-435-5056
Practice Address - Street 1:650 J ST
Practice Address - Street 2:ST 403
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68508-2900
Practice Address - Country:US
Practice Address - Phone:402-435-1313
Practice Address - Fax:402-435-5056
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE517103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE08401OtherBLUE CROSS BLUE SHIELD
NE08401OtherBLUE CROSS BLUE SHIELD