Provider Demographics
NPI:1033479134
Name:WAYMAN, GAIL ELLEN (BCBA)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:ELLEN
Last Name:WAYMAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 W PARKER RD
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3105
Mailing Address - Country:US
Mailing Address - Phone:972-212-6504
Mailing Address - Fax:972-212-6516
Practice Address - Street 1:4225 W PARKER RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3105
Practice Address - Country:US
Practice Address - Phone:972-212-6504
Practice Address - Fax:972-212-6516
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst