Provider Demographics
NPI:1902828031
Name:KNECHT LOY, GAIL RENEE (AU,D)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:RENEE
Last Name:KNECHT LOY
Suffix:
Gender:F
Credentials:AU,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 E 350 S
Mailing Address - Street 2:SUITE 9-19
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909-9184
Mailing Address - Country:US
Mailing Address - Phone:765-474-4544
Mailing Address - Fax:765-474-1122
Practice Address - Street 1:2606 E 350 S
Practice Address - Street 2:SUITE 9-19
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47909-9184
Practice Address - Country:US
Practice Address - Phone:765-474-4544
Practice Address - Fax:765-474-1122
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN23001969A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000370115OtherANTHEM PIN NUMBER