Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | SW13749 | FL |
NPI | 1003145384 |
---|---|
Provider Name | Gail Bialk |
First Address | Fort Myers, FL 33907-3989 |
Second Address | Fort Myers, FL 33907-3989 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2009 |
Last Update Date | 06/05/2021 |