| NPI | 1528432457 |
|---|---|
| Former Name | REGINA GALLAGHER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 423) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2015-11-16 |