Provider Demographics
NPI:1396915252
Name:DOSHER, GAYLE L (LMFT)
Entity type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:L
Last Name:DOSHER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:548 SW 13TH ST
Mailing Address - Street 2:204
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3184
Mailing Address - Country:US
Mailing Address - Phone:541-728-8675
Mailing Address - Fax:541-389-4005
Practice Address - Street 1:548 SW 13TH ST
Practice Address - Street 2:204
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3184
Practice Address - Country:US
Practice Address - Phone:541-728-8675
Practice Address - Fax:541-389-4005
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22580106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist