Provider Demographics
NPI:1457475394
Name:REICH, GAIL EVE (MS)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:EVE
Last Name:REICH
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 1:403 N WILD OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32118-3937
Mailing Address - Country:US
Mailing Address - Phone:386-253-2531
Mailing Address - Fax:386-253-6144
Practice Address - Street 1:403 N WILD OLIVE AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32118-3937
Practice Address - Country:US
Practice Address - Phone:386-253-2531
Practice Address - Fax:386-253-6144
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH2755101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health