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General NPI Number Information
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NPI Number | 1851489884
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Entity Type | Individual
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Provider Name | JAME H. GAMBLE LCSW
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7219 N LITCHFIELD RD BLDG. 317
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City | LUKE AFB
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State | AZ
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Zip | 85309-1529
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Country | US
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Telephone | 623-856-7579
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Fax | 623-856-4433
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Provider Business Mailing Address
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Address Line | PO BOX 1659
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-1659
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Country | US
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Telephone | 623-856-7579
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Fax | 623-856-4433
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-11921
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License Number State | AZ
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