Provider Demographics
NPI:1346366317
Name:LANKES, GAIL DIANE (COTA)
Entity Type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:DIANE
Last Name:LANKES
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4475 WAVERTREE ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7681
Mailing Address - Country:US
Mailing Address - Phone:805-543-0976
Mailing Address - Fax:
Practice Address - Street 1:4475 WAVERTREE ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7681
Practice Address - Country:US
Practice Address - Phone:805-543-0976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant