Provider Demographics
NPI:1598093593
Name:SOWER, GAIL MARIE (LLMSW)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:MARIE
Last Name:SOWER
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:MS
Other - First Name:GAIL
Other - Middle Name:MARIE
Other - Last Name:MCCANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16647 WYOMING
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221
Mailing Address - Country:US
Mailing Address - Phone:313-342-3606
Mailing Address - Fax:313-861-0413
Practice Address - Street 1:16647 WYOMING
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221
Practice Address - Country:US
Practice Address - Phone:313-342-3606
Practice Address - Fax:313-861-0413
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010917221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical