Provider Demographics
NPI:1326782640
Name:GILL, DAVID BROWN II
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BROWN
Last Name:GILL
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 DAWES CT
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-9387
Mailing Address - Country:US
Mailing Address - Phone:251-604-9417
Mailing Address - Fax:
Practice Address - Street 1:2750 DAWES CT
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-9387
Practice Address - Country:US
Practice Address - Phone:251-604-9417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMFT210101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional