Provider Demographics
NPI:1831471002
Name:WILSON, GAIL (MS)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 NW 71ST CT STE 301
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2932
Mailing Address - Country:US
Mailing Address - Phone:754-201-3090
Mailing Address - Fax:754-201-3090
Practice Address - Street 1:7710 NW 71ST CT STE 301
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2932
Practice Address - Country:US
Practice Address - Phone:754-201-3090
Practice Address - Fax:754-201-3090
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor