Provider Demographics
NPI:1215284682
Name:SMITH, GAIL MARIE (COUNSELOR)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 HOLIDAY ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2846
Mailing Address - Country:US
Mailing Address - Phone:609-980-9399
Mailing Address - Fax:
Practice Address - Street 1:212 BARCLAY PAVILION E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2137
Practice Address - Country:US
Practice Address - Phone:609-980-9399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-05
Last Update Date:2012-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional