Provider Demographics
NPI:1770749996
Name:WEISEND, GAIL (LISW - S)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:WEISEND
Suffix:
Gender:F
Credentials:LISW - S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4368 DRESSLER RD NW
Mailing Address - Street 2:#103
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2771
Mailing Address - Country:US
Mailing Address - Phone:330-433-1300
Mailing Address - Fax:330-494-0828
Practice Address - Street 1:4368 DRESSLER RD NW
Practice Address - Street 2:#103
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718
Practice Address - Country:US
Practice Address - Phone:330-433-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI1000326104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker