Provider Demographics
NPI:1467797506
Name:JAMES A GALL, PH.D., PLLC
Entity Type:Organization
Organization Name:JAMES A GALL, PH.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:GALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:810-543-1050
Mailing Address - Street 1:950 W AVON RD STE 3
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2761
Mailing Address - Country:US
Mailing Address - Phone:810-543-1050
Mailing Address - Fax:
Practice Address - Street 1:950 W AVON RD STE 3
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-2761
Practice Address - Country:US
Practice Address - Phone:810-543-1050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011878251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health