Healthcare Provider Details

I. General information

NPI: 1346373511
Provider Name (Legal Business Name): BARBARA GAIL GILLESPIE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GAIL GILLESPIE PH.D.

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 06/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 E 8TH ST
CROWLEY LA
70526-3815
US

IV. Provider business mailing address

703 E 8TH ST
CROWLEY LA
70526-3815
US

V. Phone/Fax

Practice location:
  • Phone: 337-788-1071
  • Fax: 337-788-1083
Mailing address:
  • Phone: 337-788-1071
  • Fax: 337-788-1083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number749
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: