| Doctor Name: | MR. GARY L DRAKE |
| NPI Number: | 1073506556 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | KY1429 |
| Business Practice Address: | 239 Mt Parkway Spur Campton, KY - 413010309 |
| Business Phone Number: | 6066886932 |
| Business Fax Number: | 6066683125 |
| Mailing Address: | 3209 Solutions Ctr, CHICAGO |
| State: | IL |
| Postal Code: | 606770001 |
| Phone Number: | 5022124759 |
| Fax Number: | 5024712051 |
| NPI Enumeration Date: | 08/30/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | KY1429 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |