MEDICARE: LINDSAY A WAYNE

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	222Q00000X	Developmental Therapist	0384394	MO

General Provider Information

NPI Number	:	1902022809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY A WAYNE

Provider Business Mailing Address
First Line	:	5846 PRINCE GEORGE CT
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63139-1766
Country	:	US
Telephone Number	:	314-776-1300
Fax Number	:

Provider Business Practice Location Address
First Line	:	5030 MCREE AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-2046
Country	:	US
Telephone Number	:	314-776-1300
Fax Number	:

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

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	07/08/2007

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Directions to “ LINDSAY A WAYNE ” Practice Location

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