Gray, Andrea B

Gray, Andrea B is an individual health care provider with primary practice located at 823 Park East Blvd Ste H , Lafayette IN 47905-0811. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Gray, Andrea B can be contacted via phone (765) 448-6226.

Contact Information

Primary practice address
823 Park East Blvd Ste H Lafayette IN 47905-0811
Phone: (765) 448-6226
Fax: (765) 448-9416
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 23002183A Indiana

Profile Details

NPI number 1336108612
LBN Legal business name Gray, Andrea B
Credentials MS
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Jun 2nd, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336108612 NPPES
Indiana Other 000000179545 ANTHEM PROVIDER NUMBER
Indiana MEDICAID 200180390 ANTHEM PROVIDER NUMBER
Indiana MEDICAID HA57500064 ANTHEM PROVIDER NUMBER
Indiana Other 9397785 ANTHEM PROVIDER NUMBER

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