Provider Demographics
NPI:1174215875
Name:DAY, GWENDOLYN DIONNE (RCSWI)
Entity type:Individual
Prefix:MRS
First Name:GWENDOLYN
Middle Name:DIONNE
Last Name:DAY
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:MRS
Other - First Name:GWENDOLYN
Other - Middle Name:DIONNE
Other - Last Name:DAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:711 SW 75TH ST APT 107
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-8803
Mailing Address - Country:US
Mailing Address - Phone:352-222-9685
Mailing Address - Fax:
Practice Address - Street 1:711 SW 75TH ST APT 107
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-8803
Practice Address - Country:US
Practice Address - Phone:352-222-9685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW187791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical