Provider Demographics
NPI:1447416599
Name:TINSMAN, GALE
Entity Type:Individual
Prefix:
First Name:GALE
Middle Name:
Last Name:TINSMAN
Suffix:
Gender:F
Credentials:
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 1589
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72018-1589
Mailing Address - Country:US
Mailing Address - Phone:870-258-3305
Mailing Address - Fax:870-258-3244
Practice Address - Street 1:105 HWY 9
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AR
Practice Address - Zip Code:72565
Practice Address - Country:US
Practice Address - Phone:870-258-3305
Practice Address - Fax:879-258-3244
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1004049101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health