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NPI Code Detail

MEDICARE: MS. GAILANN THATCHER PROCACCINI MS

MEDICARE: MS. GAILANN THATCHER PROCACCINI MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1427186642
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GAILANN THATCHER PROCACCINI MS
Provider Business Mailing Address
First Line : 3496 TABB DR
Second Line :
City : DELTONA
State : FL
Zip : 32738-9461
Country : US
Telephone Number : 386-469-1544
Fax Number :
Provider Business Practice Location Address
First Line : 1251 N STONE ST
Second Line :
City : DELAND
State : FL
Zip : 32720-2584
Country : US
Telephone Number : 386-469-1544
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 07/08/2007

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