Provider Demographics
NPI:1144407719
Name:DENNING-MAILLOUX, GALE MARIE (MA)
Entity Type:Individual
Prefix:
First Name:GALE
Middle Name:MARIE
Last Name:DENNING-MAILLOUX
Suffix:
Gender:F
Credentials:MA
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 665
Mailing Address - Street 2:
Mailing Address - City:BONSALL
Mailing Address - State:CA
Mailing Address - Zip Code:92003-0665
Mailing Address - Country:US
Mailing Address - Phone:760-726-1625
Mailing Address - Fax:760-726-9980
Practice Address - Street 1:30016 DISNEY LN
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-1228
Practice Address - Country:US
Practice Address - Phone:760-726-1625
Practice Address - Fax:760-726-9980
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-26
Last Update Date:2008-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31949106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist