Individual
GAYLE ANN ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BAA,CPCT,BAT
Contact information
Practice address
1802 WILDWOOD ST STE B, VICTORIA, TX 77901-7166
(361) 596-3651
(361) 600-2093
Mailing address
1802 WILDWOOD ST STE B, VICTORIA, TX 77901-7166
(361) 596-3651
(361) 600-2093
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
347C00000X
Private Vehicle
25894411
TX
Other
Enumeration date
04/04/2014
Last updated
08/23/2021
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