| Doctor Name: | AILEEN KATHLEEN GAYNOR |
| NPI Number: | 1619183761 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | CATC# 061326 |
| Business Practice Address: | 221 S Lenore Ave # B Willits, CA - 954903632 |
| Business Phone Number: | 7074563820 |
| Business Fax Number: | |
| Mailing Address: | 221 B South Lenore St., WILLITS |
| State: | CA |
| Postal Code: | 95490 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/15/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | CATC# 061326 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |