Provider Demographics
NPI:1073061636
Name:GALLAGHER, LISA MAUREEN (ND)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:MAUREEN
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7686 CINCINNATI DAYTON RD STE A-1
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-3098
Mailing Address - Country:US
Mailing Address - Phone:513-223-3216
Mailing Address - Fax:
Practice Address - Street 1:7686 CINCINNATI DAYTON RD STE A-1
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-3098
Practice Address - Country:US
Practice Address - Phone:513-223-3216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-13
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 60249423175F00000X
WA60249423175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath