Provider Demographics
NPI:1093153686
Name:PESSES, GAIL FENTON
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:FENTON
Last Name:PESSES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 CLEARVIEW PKWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2371
Mailing Address - Country:US
Mailing Address - Phone:504-885-1442
Mailing Address - Fax:504-885-1441
Practice Address - Street 1:4500 CLEARVIEW PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2371
Practice Address - Country:US
Practice Address - Phone:504-885-1442
Practice Address - Fax:504-885-1441
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA40381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical