Provider Demographics
NPI:1043209737
Name:GALLION, KATHLEEN ANN (AU D)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:ANN
Last Name:GALLION
Suffix:
Gender:F
Credentials:AU D
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:ANN
Other - Last Name:ANDOLSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 CANDYTUFT LN
Mailing Address - Street 2:
Mailing Address - City:OCEAN PINES
Mailing Address - State:MD
Mailing Address - Zip Code:21811-2050
Mailing Address - Country:US
Mailing Address - Phone:443-496-0930
Mailing Address - Fax:
Practice Address - Street 1:8468 HERRING RUN RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-5763
Practice Address - Country:US
Practice Address - Phone:302-629-3400
Practice Address - Fax:302-629-5300
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE02-0000155231H00000X
DE03-0000229237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0004/F190OtherPREFERRED/BCBS FEDERAL
60710101OtherCAREFIRST BC/BS
298234OtherMAPSI/ALLIANCE/MAMSI
2883752OtherAETNA/US HEALTHCARE
640004643OtherRAILROAD MEDICARE
0004/F190OtherCAREFIRST BLUE CHOICE
298234OtherMDIPA/OPTIMUM CHOICE
7234296OtherAETNA/US HEALTHCARE
5152517OtherCIGNA
MD474LA107Medicare PIN
2883752OtherAETNA/US HEALTHCARE