Individual
MRS. GAIL PATRICIA KAILBOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CSP, LPC
Contact information
Practice address
2714 IDLEWOOD LN, STATESVILLE, NC 28625-4729
(704) 838-4040
(704) 838-7668
Mailing address
2714 IDLEWOOD LN, STATESVILLE, NC 28625-4729
(704) 838-4040
(704) 838-7668
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LPC-5113
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103337
—
NC
Enumeration date
01/17/2007
Last updated
09/26/2012
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