Provider Demographics
NPI:1881279230
Name:GAINES, LINDSEY (HIS)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:GAINES
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:LANGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2524 CAROLYN DR # 502
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77632-5222
Mailing Address - Country:US
Mailing Address - Phone:909-264-0262
Mailing Address - Fax:
Practice Address - Street 1:114 W PRIEN LAKE RD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8571
Practice Address - Country:US
Practice Address - Phone:337-310-0632
Practice Address - Fax:337-436-2153
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1328237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist