Healthcare Provider Details

I. General information

NPI: 1811037195
Provider Name (Legal Business Name): INTERACTIONS THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 03/13/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 SPRING ST., SUITE 101
GALENA IL
61036
US

IV. Provider business mailing address

800 SPRING ST., SUITE 101
GALENA IL
61036
US

V. Phone/Fax

Practice location:
  • Phone: 815-777-2850
  • Fax: 815-550-0529
Mailing address:
  • Phone: 815-777-2850
  • Fax: 815-550-0529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number166-000220
License Number StateIL

VIII. Authorized Official

Name: DR. GAIL LYNN GABBERT
Title or Position: LMFT
Credential: LMFT
Phone: 815-777-2850