MEDICARE: MS. GAIL MARIE LAWSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	7405-S	NV

General Provider Information

NPI Number	:	1528424744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GAIL MARIE LAWSON

Provider Business Mailing Address
First Line	:	10641 SAN SICILY ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-0457
Country	:	US
Telephone Number	:	702-875-1605
Fax Number	:	702-837-8914

Provider Business Practice Location Address
First Line	:	10641 SAN SICILY ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-0457
Country	:	US
Telephone Number	:	702-875-1605
Fax Number	:	702-837-8914

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2016
Last Update Date	:	02/04/2017

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