Provider Demographics
NPI:1407987928
Name:GILBERT, LAURIE ELYSE (PHD)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ELYSE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5819 OLD HARDING RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-3619
Mailing Address - Country:US
Mailing Address - Phone:615-352-4439
Mailing Address - Fax:615-352-4095
Practice Address - Street 1:5819 OLD HARDING RD
Practice Address - Street 2:SUITE 204
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-3619
Practice Address - Country:US
Practice Address - Phone:615-352-4439
Practice Address - Fax:615-352-4095
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000001148103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist