Provider Demographics
NPI:1811325327
Name:GILLEY, SANDRA GAIL (LMHC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:GAIL
Last Name:GILLEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:GAIL
Other - Last Name:BOSHEERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:10020 CELTIC ASH DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33573-6729
Mailing Address - Country:US
Mailing Address - Phone:813-922-5273
Mailing Address - Fax:
Practice Address - Street 1:710 OAKFIELD DR STE 221
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4924
Practice Address - Country:US
Practice Address - Phone:813-922-5273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-18
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health