Doctor Name: | GAYLE EATON |
NPI Number: | 1124170337 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LCSW853 |
Business Practice Address: | 402 Old State Hwy Cascade, ID - 83611 |
Business Phone Number: | 2083824242 |
Business Fax Number: | 2083825081 |
Mailing Address: | Po Box 1330, CASCADE |
State: | ID |
Postal Code: | 836111330 |
Phone Number: | 2083824242 |
Fax Number: | 2083825081 |
NPI Enumeration Date: | 01/17/2007 |
NPI Last Update Date: | 02/25/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCSW853 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |