| Doctor Name: | MR. GARY R. PICKERING |
| NPI Number: | 1659602092 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.DIV. M.S. |
| License Number: | MH 9960 |
| Business Practice Address: | 106 S Main St Bushnell, FL - 335137306 |
| Business Phone Number: | 3524384847 |
| Business Fax Number: | |
| Mailing Address: | 35120 Millrock St, WEBSTER |
| State: | FL |
| Postal Code: | 335979067 |
| Phone Number: | 3524384847 |
| Fax Number: | |
| NPI Enumeration Date: | 01/25/2010 |
| NPI Last Update Date: | 01/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH 9960 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |