Provider Demographics
NPI:1073207684
Name:GAKIRE, JEAN THIERRY
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:THIERRY
Last Name:GAKIRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8436 W ENCINAS LN
Mailing Address - Street 2:
Mailing Address - City:TOLLESON
Mailing Address - State:AZ
Mailing Address - Zip Code:85353-5707
Mailing Address - Country:US
Mailing Address - Phone:915-603-7020
Mailing Address - Fax:
Practice Address - Street 1:8436 W ENCINAS LN
Practice Address - Street 2:
Practice Address - City:TOLLESON
Practice Address - State:AZ
Practice Address - Zip Code:85353-5707
Practice Address - Country:US
Practice Address - Phone:915-603-7020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty