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NPI Code Detail

MEDICARE: MS. SUE ANN GILLES MSW

MEDICARE: MS. SUE ANN GILLES MSW
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
11041S0200XSchool Social WorkerSW0122IAZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841331170
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUE ANN GILLES MSW
Provider Business Mailing Address
First Line : 701 W WETMORE ROAD
Second Line : AMPHITHEATER PUBLIC SCHOOLS
City : TUCSON
State : AZ
Zip : 85705-1547
Country : US
Telephone Number : 520-696-5237
Fax Number : 520-696-5067
Provider Business Practice Location Address
First Line : 701 W WETMORE ROAD
Second Line : AMPHITHEATER PUBLIC SCHOOLS
City : TUCSON
State : AZ
Zip : 85705-1547
Country : US
Telephone Number : 520-696-5237
Fax Number : 520-696-5067
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2007
Last Update Date : 07/08/2007

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