Provider Demographics
NPI:1427186642
Name:PROCACCINI, GAILANN THATCHER (MS)
Entity Type:Individual
Prefix:MS
First Name:GAILANN
Middle Name:THATCHER
Last Name:PROCACCINI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3496 TABB DR
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32738-9461
Mailing Address - Country:US
Mailing Address - Phone:386-469-1544
Mailing Address - Fax:
Practice Address - Street 1:1251 N STONE ST
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-2584
Practice Address - Country:US
Practice Address - Phone:386-469-1544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor