Provider Demographics
NPI:1205130358
Name:GILE, ANN M (MS MFT SACT)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:GILE
Suffix:
Gender:F
Credentials:MS MFT SACT
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:M
Other - Last Name:VINGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10 KINGS MILL CIR UNIT 214
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53718-3411
Mailing Address - Country:US
Mailing Address - Phone:608-214-7152
Mailing Address - Fax:
Practice Address - Street 1:300 FEMRITE DR
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53716-3716
Practice Address - Country:US
Practice Address - Phone:608-222-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15368-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI15368-130OtherSUBSTANCE ABUSE COUNSELOR