Individual
DEBORAH JOY GILCREST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFTI
Contact information
Practice address
714 W. MAIN ST., GRASS VALLEY, CA 95945
(530) 477-9800
(530) 477-9803
Mailing address
714 W. MAIN ST., GRASS VALLEY, CA 95945
(530) 477-9800
(530) 477-9803
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
IMF 57150
CA
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/03/2007
Last updated
09/03/2008
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