Provider Demographics
NPI:1548643547
Name:REESE, GAIL E (BCBA)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:E
Last Name:REESE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MS
Other - First Name:GAIL
Other - Middle Name:E
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5630 GLADE VIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:VA
Mailing Address - Zip Code:22812
Mailing Address - Country:US
Mailing Address - Phone:540-908-1457
Mailing Address - Fax:
Practice Address - Street 1:5630 GLADE VIEW DRIVE
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:VA
Practice Address - Zip Code:22812
Practice Address - Country:US
Practice Address - Phone:540-908-1457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-08-4482103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst