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NPI Code Detail

MEDICARE: DAKIYAH LEANN GAMBLE

MEDICARE: DAKIYAH LEANN GAMBLE
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
1106S00000XBehavior Technician9370990425IN

General Provider Information

NPI Number : 1417814294
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAKIYAH LEANN GAMBLE
Provider Business Mailing Address
First Line : 129 S 2ND AVE
Second Line :
City : BEECH GROVE
State : IN
Zip : 46107-1904
Country : US
Telephone Number : 765-696-9967
Fax Number :
Provider Business Practice Location Address
First Line : 129 S 2ND AVE
Second Line :
City : BEECH GROVE
State : IN
Zip : 46107-1904
Country : US
Telephone Number : 765-696-9967
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “ DAKIYAH LEANN GAMBLE ” Practice Location

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