Provider Demographics
NPI:1528409893
Name:SAUER, GAYLE MARY (LCDC-I)
Entity Type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:MARY
Last Name:SAUER
Suffix:
Gender:F
Credentials:LCDC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2706 BENEVENTO WAY
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4306
Mailing Address - Country:US
Mailing Address - Phone:512-551-3416
Mailing Address - Fax:
Practice Address - Street 1:2706 BENEVENTO WAY
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4306
Practice Address - Country:US
Practice Address - Phone:512-551-3416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20634101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)