| Mary Ann Gansle Sole Mbr | |
|
1700 Wildcat Dr Ste D Portland TX 78374-2817 | |
| (361) 445-4080 | |
| (888) 413-3010 |
| Full Name | Mary Ann Gansle Sole Mbr |
|---|---|
| Speciality | Psychologist |
| Location | 1700 Wildcat Dr Ste D, Portland, Texas |
| Authorized Official Name and Position | Mary Ann Gansle (PSYCHOLOGIST) |
| Authorized Official Contact | 3614454080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Ann Gansle Sole Mbr Po Box 2 Portland TX 78374-0002 Ph: (361) 445-4080 | Mary Ann Gansle Sole Mbr 1700 Wildcat Dr Ste D Portland TX 78374-2817 Ph: (361) 445-4080 |
| NPI Number | 1629346606 |
|---|---|
| Provider Enumeration Date | 12/06/2011 |
| Last Update Date | 12/06/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629346606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 35139 (Texas) | Primary |
Coastal Plains Community Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Marriott Dr, Portland, TX 78374 Phone: 361-777-3991 Fax: 361-777-0610 | |
Richard L Reitmann Lpc Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1700 Wildcat Dr Ste D, Portland, TX 78374 Phone: 361-445-4080 | |
Coastal Plains Community Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Marriott Drive, Portland, TX 78374 Phone: 361-777-3991 Fax: 361-777-0610 | |
Coastal Plains Community Mhmr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Marriott Dr, Portland, TX 78374 Phone: 361-777-3991 | |
Coastal Plains Community Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 200 Marriott Dr, Portland, TX 78374 Phone: 361-777-3991 Fax: 361-777-0610 |