Provider Demographics
NPI:1760487524
Name:VANCE, GAYE B (PHD)
Entity Type:Individual
Prefix:MRS
First Name:GAYE
Middle Name:B
Last Name:VANCE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 HIGHWAY 33
Mailing Address - Street 2:UNIT A
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-4887
Mailing Address - Country:US
Mailing Address - Phone:205-664-4010
Mailing Address - Fax:205-664-9928
Practice Address - Street 1:1940 HIGHWAY 33
Practice Address - Street 2:UNIT A
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-4887
Practice Address - Country:US
Practice Address - Phone:205-664-4010
Practice Address - Fax:205-664-9928
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL581103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51035006OtherBLUE CROSS
AL012981OtherVALUE OPTIONS
AL51099218OtherBLUE CROSS OTHER
AL012981OtherVALUE OPTIONS