Provider Demographics
NPI:1750046017
Name:GASKIN-BUTLER, VIKKI TWYNETTE (PHD)
Entity type:Individual
Prefix:DR
First Name:VIKKI
Middle Name:TWYNETTE
Last Name:GASKIN-BUTLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9784 POPLAR PL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-6840
Mailing Address - Country:US
Mailing Address - Phone:727-644-9471
Mailing Address - Fax:
Practice Address - Street 1:9784 POPLAR PL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-6840
Practice Address - Country:US
Practice Address - Phone:727-644-9471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9892103TC0700X
GA002648103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical