Provider Demographics
NPI:1962559690
Name:WALKER, GAIL RUSK (LPC)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:RUSK
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:GAIL
Other - Middle Name:LYNN
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:604 HIGHWAY 80 W
Mailing Address - Street 2:SUITE N
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056
Mailing Address - Country:US
Mailing Address - Phone:601-201-5593
Mailing Address - Fax:601-925-1722
Practice Address - Street 1:604 HIGHWAY 80 W
Practice Address - Street 2:SUITE N
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-4108
Practice Address - Country:US
Practice Address - Phone:601-201-5593
Practice Address - Fax:601-925-1722
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0586101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional