| Gayle Walls-brown Pllc | |
|
20700 Civic Center Dr 170 Southfield MI 48076-4140 | |
| (313) 610-5711 | |
| Not Available |
| Full Name | Gayle Walls-brown Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 20700 Civic Center Dr, Southfield, Michigan |
| Authorized Official Name and Position | Gayle Elaine Walls-brown (CLINICAL THERAPIST) |
| Authorized Official Contact | 3136105711 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gayle Walls-brown Pllc 19670 Chesterfield Rd Detroit MI 48221-1831 Ph: (313) 610-5711 | Gayle Walls-brown Pllc 20700 Civic Center Dr 170 Southfield MI 48076-4140 Ph: (313) 610-5711 |
| NPI Number | 1861692824 |
|---|---|
| Provider Enumeration Date | 07/18/2007 |
| Last Update Date | 07/18/2007 |
| Medicare PECOS PAC ID | 2961593538 |
|---|---|
| Medicare Enrollment ID | O20070810000585 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861692824 | NPI | - | NPPES |
| 1588772560 | Other | MI | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6801080183 (Michigan) | Primary |
| Provider Name | Gayle E Walls Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588772560 PECOS PAC ID: 2668479874 Enrollment ID: I20061101000234 |
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