Provider Demographics
NPI:1831343904
Name:LYNN, GAIL WENDY (MA,CCC)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:WENDY
Last Name:LYNN
Suffix:
Gender:F
Credentials:MA,CCC
Other - Prefix:MISS
Other - First Name:GAIL
Other - Middle Name:WENDY
Other - Last Name:GELFOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2082 HAMPTON WAY
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-5024
Mailing Address - Country:US
Mailing Address - Phone:516-312-8592
Mailing Address - Fax:516-379-0457
Practice Address - Street 1:2082 HAMPTON WAY
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-5024
Practice Address - Country:US
Practice Address - Phone:516-312-8592
Practice Address - Fax:516-379-0457
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-15
Last Update Date:2008-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist