Provider Demographics
NPI:1265955330
Name:LINDLEY, GAIL THERESE (CCC/SLP)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:THERESE
Last Name:LINDLEY
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 KYLE CT
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5784
Mailing Address - Country:US
Mailing Address - Phone:817-944-3553
Mailing Address - Fax:
Practice Address - Street 1:550 SILICON DR STE 100
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7524
Practice Address - Country:US
Practice Address - Phone:817-944-3553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17767235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist