Provider Demographics
NPI:1871709766
Name:GILL, ADELE MORALES (LAC)
Entity type:Individual
Prefix:MS
First Name:ADELE
Middle Name:MORALES
Last Name:GILL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:9546 MANY MILE MEWS
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2804
Mailing Address - Country:US
Mailing Address - Phone:301-490-0165
Mailing Address - Fax:301-490-3228
Practice Address - Street 1:10716 LITTLE PATUXENT PARKWAY
Practice Address - Street 2:210
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3117
Practice Address - Country:US
Practice Address - Phone:301-490-0165
Practice Address - Fax:301-490-3228
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDU01100171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist