Provider Demographics
NPI:1427076132
Name:HUECKER, GAIL E (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:E
Last Name:HUECKER
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 JONQUIL CT
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6677
Mailing Address - Country:US
Mailing Address - Phone:704-696-8344
Mailing Address - Fax:
Practice Address - Street 1:335 NE 10TH AVE
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-4456
Practice Address - Country:US
Practice Address - Phone:352-795-5552
Practice Address - Fax:352-795-7751
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT8510222Q00000X, 225X00000X
NC9010225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL884408900Medicaid
FLZ9082OtherBLUE CROSS BLUE SHIELD
FL1427076132OtherTRI-CARE
FL1244904OtherUNITED HEALTHCARE
NC1427076132Medicaid