Provider Demographics
NPI:1720025539
Name:JOSLIN, GALE L (PHD)
Entity Type:Individual
Prefix:DR
First Name:GALE
Middle Name:L
Last Name:JOSLIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 W FAIRMONT ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-6303
Mailing Address - Country:US
Mailing Address - Phone:903-757-8161
Mailing Address - Fax:903-757-8650
Practice Address - Street 1:1508 W FAIRMONT ST
Practice Address - Street 2:SUITE C
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-6303
Practice Address - Country:US
Practice Address - Phone:903-757-8161
Practice Address - Fax:903-757-8650
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21837103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00G89CMedicare ID - Type UnspecifiedPROVIDER NUMBER