Provider Demographics
NPI:1265249106
Name:NIETO, GISELLE ALHAI
Entity type:Individual
Prefix:
First Name:GISELLE
Middle Name:ALHAI
Last Name:NIETO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36515 N DILLEYS RD
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-1717
Mailing Address - Country:US
Mailing Address - Phone:224-413-0903
Mailing Address - Fax:
Practice Address - Street 1:36515 N DILLEYS RD
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-1717
Practice Address - Country:US
Practice Address - Phone:224-413-0903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician