Provider Demographics
NPI:1205126455
Name:GIL, GRETCHEN M (PSY, D)
Entity type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:M
Last Name:GIL
Suffix:
Gender:F
Credentials:PSY, D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CORPORATE OFFICE PARK
Mailing Address - Street 2:ASG SUITE 301
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:787-800-9294
Mailing Address - Fax:
Practice Address - Street 1:CORPORATE OFFICE PARK
Practice Address - Street 2:ASG SUITE 301
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-800-9294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3879103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical