Provider Demographics
NPI:1891122602
Name:GAMBLE, BARBARA (MS, LLP)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:GAMBLE
Suffix:
Gender:F
Credentials:MS, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 E WASHINGTON ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2017
Mailing Address - Country:US
Mailing Address - Phone:734-646-6406
Mailing Address - Fax:
Practice Address - Street 1:202 E WASHINGTON ST
Practice Address - Street 2:SUITE 308
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2017
Practice Address - Country:US
Practice Address - Phone:734-646-6406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-11
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014824103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical