Organization
GAYLE WALLS-BROWN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GAYLE ELAINE WALLS-BROWN LMSW, ACSW (CLINICAL THERAPIST)
(313) 610-5711
Entity
Organization
Contact information
Practice address
20700 CIVIC CENTER DR, 170, SOUTHFIELD, MI 48076-4140
(313) 610-5711
Mailing address
19670 CHESTERFIELD RD, DETROIT, MI 48221-1831
(313) 610-5711
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6801080183
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588772560
INDIVIDUAL NPI
MI
Enumeration date
07/18/2007
Last updated
07/18/2007
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