Doctor Name: | JACQUELYN ANN GAILEY |
NPI Number: | 1053484303 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW |
License Number: | I 0002359 |
Business Practice Address: | 14843 W Sprague Rd Suite A Strongsville, OH - 441361754 |
Business Phone Number: | 4402349955 |
Business Fax Number: | 4402345994 |
Mailing Address: | 732 Village Club Rd, SAGAMORE HILLS |
State: | OH |
Postal Code: | 440672300 |
Phone Number: | 3304685248 |
Fax Number: | |
NPI Enumeration Date: | 11/16/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I 0002359 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |