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NPI 1891984464

NPI 1891984464 : GAIL MARTIN LCSW : DALLAS, TX

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General NPI Number Information
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    NPI Number           |    1891984464
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    Entity Type          |    Individual 
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    Provider Name        |    GAIL MARTIN LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/19/2007
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    Last Update Date     |    02/17/2009
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Provider Practice Location Address
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    Address Line         |    3585 TIMBERGLEN RD 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75287-3424
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    Country              |    US
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    Telephone            |    972-662-5112
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    Fax                  |    817-887-5540
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Provider Business Mailing Address
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    Address Line         |    8409 SONNET DR 
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    City                 |    MCKINNEY
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    State                |    TX
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    Zip                  |    75071-4723
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    Country              |    US
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    Telephone            |    972-662-5112
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    Fax                  |    817-887-5540
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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       |    14386
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    License Number State |    TX
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