Provider Demographics
NPI:1477237451
Name:GAMBILL, ANNE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:GAMBILL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAPC, LPC
Mailing Address - Street 1:6675 SCOTLAND CIR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-3009
Mailing Address - Country:US
Mailing Address - Phone:706-818-1823
Mailing Address - Fax:
Practice Address - Street 1:671 LUMPKIN CAMPGROUND RD S
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-0922
Practice Address - Country:US
Practice Address - Phone:678-866-8777
Practice Address - Fax:678-866-8776
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013897101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional