Provider Demographics
NPI:1114278223
Name:AUEL, GAHLYA (EDS, NCSP)
Entity Type:Individual
Prefix:
First Name:GAHLYA
Middle Name:
Last Name:AUEL
Suffix:
Gender:F
Credentials:EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E SPENCER LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-7307
Mailing Address - Country:US
Mailing Address - Phone:360-427-2931
Mailing Address - Fax:
Practice Address - Street 1:110 E SPENCER LAKE RD
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-7307
Practice Address - Country:US
Practice Address - Phone:360-427-2931
Practice Address - Fax:360-427-2933
Is Sole Proprietor?:No
Enumeration Date:2012-09-28
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA474896H103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool