MEDICARE: MRS. LINDSAY GAYLE

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1164652236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDSAY GAYLE

Provider Business Mailing Address
First Line	:	6399 HAZELWOOD AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-4713
Country	:	US
Telephone Number	:	812-599-7810
Fax Number	:

Provider Business Practice Location Address
First Line	:	5401 N HIGH SCHOOL RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-1612
Country	:	US
Telephone Number	:	317-299-1266
Fax Number	:

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

Provider Enumeration Date	:	07/22/2009
Last Update Date	:	07/22/2009

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