Provider Demographics
NPI:1235332560
Name:GILL, ENGRACCA BAUTIL (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ENGRACCA
Middle Name:BAUTIL
Last Name:GILL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3421 BEE CAVES RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746
Mailing Address - Country:US
Mailing Address - Phone:512-680-2784
Mailing Address - Fax:512-402-0627
Practice Address - Street 1:3421 BEE CAVES RD
Practice Address - Street 2:SUITE 2
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-680-2784
Practice Address - Fax:512-402-0627
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX365361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical