Provider Demographics
NPI:1770957367
Name:JAFFE SATULOFF, GAIL
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:JAFFE SATULOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TERRY MINDFULNESS CENTER, 333 17TH ST.
Mailing Address - Street 2:SUITE 2T
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960
Mailing Address - Country:US
Mailing Address - Phone:772-559-6094
Mailing Address - Fax:
Practice Address - Street 1:TERRY MINDFULNESS CENTER, 333 17TH ST.
Practice Address - Street 2:SUITE 2T
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960
Practice Address - Country:US
Practice Address - Phone:772-559-6094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH000312101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional