Provider Demographics
NPI:1063756864
Name:TINKER, GAIL-ELAINE (MS,RM,CH, NCC, LPC)
Entity type:Individual
Prefix:
First Name:GAIL-ELAINE
Middle Name:
Last Name:TINKER
Suffix:
Gender:F
Credentials:MS,RM,CH, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 PARK PL
Mailing Address - Street 2:#100
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-4324
Mailing Address - Country:US
Mailing Address - Phone:610-216-4319
Mailing Address - Fax:
Practice Address - Street 1:547 PARK PL
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-4324
Practice Address - Country:US
Practice Address - Phone:610-216-4319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-16
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008050101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC008050OtherLICENSE