Doctor Name: | MRS. GAYLE RINI TELFORD |
NPI Number: | 1033480892 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW |
License Number: | 943907 |
Business Practice Address: | 3610 W Market St Suite 102 Fairlawn, OH - 443339301 |
Business Phone Number: | 4405671416 |
Business Fax Number: | |
Mailing Address: | 138 Pineland Dr, COPLEY |
State: | OH |
Postal Code: | 443211320 |
Phone Number: | 4405671416 |
Fax Number: | |
NPI Enumeration Date: | 01/25/2012 |
NPI Last Update Date: | 02/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 943907 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |