Provider Demographics
NPI:1578569208
Name:NELDON, GAYLE (MS)
Entity Type:Individual
Prefix:MRS
First Name:GAYLE
Middle Name:
Last Name:NELDON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6122
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-6122
Mailing Address - Country:US
Mailing Address - Phone:304-293-2687
Mailing Address - Fax:304-293-7565
Practice Address - Street 1:805 ALLEN HALL
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-6122
Practice Address - Country:US
Practice Address - Phone:304-293-2687
Practice Address - Fax:304-293-7565
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVA-0076231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist