Basic Information
Provider Information
NPI: 1821682519
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GAYLER
FirstName: CHRISTOPHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1100 SHAWNEE RD
Address2:  
City: LIMA
State: OH
PostalCode: 458053583
CountryCode: US
TelephoneNumber: 4199992010
FaxNumber: 4199996284
Practice Location
Address1: 1 COUNTRY LN
Address2:  
City: BROOKVILLE
State: OH
PostalCode: 453099268
CountryCode: US
TelephoneNumber: 9378332133
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/24/2021
LastUpdateDate: 02/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000XS.1302788OHY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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