Provider Demographics
NPI:1619161668
Name:ATTAKORA, GAIL (LICSW)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:ATTAKORA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5202 ZEPHYR AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-1565
Mailing Address - Country:US
Mailing Address - Phone:301-297-7284
Mailing Address - Fax:
Practice Address - Street 1:515 44TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-8043
Practice Address - Country:US
Practice Address - Phone:301-297-7284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500781861041C0700X
MD134711041C0700X
VA09040064081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical