Provider Demographics
NPI:1497845713
Name:WULBRECHT, GAIL YVONNE
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:YVONNE
Last Name:WULBRECHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:YVONNE
Other - Last Name:ORNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2383 W MUSKET WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-8423
Mailing Address - Country:US
Mailing Address - Phone:480-792-6658
Mailing Address - Fax:
Practice Address - Street 1:4035 W CHANDLER BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3772
Practice Address - Country:US
Practice Address - Phone:480-329-0596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10532101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health