Provider Demographics
NPI:1528608346
Name:GILKEY, DENEISHA MAI
Entity type:Individual
Prefix:
First Name:DENEISHA
Middle Name:MAI
Last Name:GILKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 UNION AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-5408
Mailing Address - Country:US
Mailing Address - Phone:612-964-4951
Mailing Address - Fax:
Practice Address - Street 1:457 UNION AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-5408
Practice Address - Country:US
Practice Address - Phone:612-964-4951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician