Provider Demographics
NPI:1093426736
Name:GALE, PEPPER (LCSW)
Entity Type:Individual
Prefix:
First Name:PEPPER
Middle Name:
Last Name:GALE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1121
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:UT
Mailing Address - Zip Code:84713-1121
Mailing Address - Country:US
Mailing Address - Phone:435-310-1080
Mailing Address - Fax:
Practice Address - Street 1:BEAVER VALLEY HOSPITAL
Practice Address - Street 2:1109 N 100 W
Practice Address - City:BEAVER
Practice Address - State:UT
Practice Address - Zip Code:84713
Practice Address - Country:US
Practice Address - Phone:435-438-7183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7221465-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical