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Individual

GAYLE M TATE-CASSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
600 BROADWAY ST, LONGVIEW, WA 98632-3256
(360) 414-2222
(360) 414-2220
Mailing address
PO BOX 249, LONGVIEW, WA 98632-7154
(360) 414-2048
(360) 414-2054

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
LW00006409
WA
1041C0700X
Clinical Social Worker
Primary
LW00006409
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8923628
CRIME VICTIMS
WA
Enumeration date
09/07/2005
Last updated
10/12/2011
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