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General NPI Number Information
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NPI Number | 1639579741
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Entity Type | Individual
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Provider Name | GALE SIMON M.A., L.P.C., N.C.C.
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Gender | Female
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Dates
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Enumeration Date | 08/26/2014
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Last Update Date | 08/26/2014
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Provider Practice Location Address
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Address Line | 50630 CHESTERFIELD RD
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City | CHESTERFIELD
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State | MI
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Zip | 48051-4009
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Country | US
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Telephone | 586-949-7680
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Fax |
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Provider Business Mailing Address
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Address Line | 6352 MARINA DR
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City | CLAY
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State | MI
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Zip | 48001-4254
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Country | US
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Telephone | 810-300-3357
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401007260
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License Number State | MI
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