Provider Demographics
NPI:1174876791
Name:SIMPSON, GAIL MARIAN (PCC-S)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:MARIAN
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 GREENSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45431-8604
Mailing Address - Country:US
Mailing Address - Phone:937-429-2170
Mailing Address - Fax:
Practice Address - Street 1:1349 E STROOP RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-4925
Practice Address - Country:US
Practice Address - Phone:937-603-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0002738101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional