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Individual

DR. GAIL CASSANDRA BROTHERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
6421 CAMP BOWIE BLVD, SUITE 306, FORT WORTH, TX 76116-5401
(817) 689-4744
(817) 207-0704
Mailing address
PO BOX 101011, FORT WORTH, TX 76185-1011
(817) 689-4744
(817) 207-0704

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
25595
TX
103TC2200X
Clinical Child & Adolescent Psychologist
25595
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1172603-04
TX
Enumeration date
11/01/2006
Last updated
01/13/2016
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