MEDICARE: MS. GAYLE J MURRAY LISW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	02223	IA

General Provider Information

NPI Number	:	1710948328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GAYLE J MURRAY LISW

Provider Business Mailing Address
First Line	:	2327 70TH ST
Second Line	:	WADLE AND ASSOCIATES PC
City	:	DES MOINES
State	:	IA
Zip	:	50322
Country	:	US
Telephone Number	:	515-270-1344
Fax Number	:	515-270-6515

Provider Business Practice Location Address
First Line	:	2327 70TH ST
Second Line	:	WADLE AND ASSOCIATES PC
City	:	DES MOINES
State	:	IA
Zip	:	50322
Country	:	US
Telephone Number	:	515-270-1344
Fax Number	:	515-270-6515

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	07/08/2007

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