Provider Demographics
NPI:1750725545
Name:GARRETT, GAIL L
Entity type:Individual
Prefix:MISS
First Name:GAIL
Middle Name:L
Last Name:GARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:L
Other - Last Name:HAYWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5370 E CRAIG RD
Mailing Address - Street 2:APT 1440
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-2100
Mailing Address - Country:US
Mailing Address - Phone:702-408-0397
Mailing Address - Fax:
Practice Address - Street 1:5370 E CRAIG RD
Practice Address - Street 2:APT 1440
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89115-2100
Practice Address - Country:US
Practice Address - Phone:702-408-0397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst