Provider Demographics
NPI:1598807687
Name:GAULEY, MARIE (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:
Last Name:GAULEY
Suffix:
Gender:F
Credentials:MA, LMFT
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 2004
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92286-2004
Mailing Address - Country:US
Mailing Address - Phone:760-831-1935
Mailing Address - Fax:760-369-0735
Practice Address - Street 1:60208 ABERDEEN DR
Practice Address - Street 2:
Practice Address - City:JOSHUA TREE
Practice Address - State:CA
Practice Address - Zip Code:92252-4163
Practice Address - Country:US
Practice Address - Phone:760-831-1935
Practice Address - Fax:760-369-0735
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34128106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist