Provider Demographics
NPI:1386765543
Name:RESH, GAYLE LYNN (CTRS)
Entity type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:LYNN
Last Name:RESH
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W PROSPECTOR PL
Mailing Address - Street 2:P.O. BOX 94949
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68522-1970
Mailing Address - Country:US
Mailing Address - Phone:402-479-5272
Mailing Address - Fax:402-479-5238
Practice Address - Street 1:801 W PROSPECTOR PL
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68522-1970
Practice Address - Country:US
Practice Address - Phone:402-479-5272
Practice Address - Fax:402-479-5238
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist