Provider Demographics
NPI:1568254258
Name:GILL, DEANNA M (MA)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:M
Last Name:GILL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:MARIE
Other - Last Name:SEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2409 BEMISS RD
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1936
Mailing Address - Country:US
Mailing Address - Phone:229-251-5151
Mailing Address - Fax:
Practice Address - Street 1:2409 BEMISS RD
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1936
Practice Address - Country:US
Practice Address - Phone:229-251-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC015765101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional