Provider Demographics
NPI:1073121497
Name:GALLIHER, RENEE
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:GALLIHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2151 W EVANS ST STE J
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4085
Mailing Address - Country:US
Mailing Address - Phone:843-661-5049
Mailing Address - Fax:
Practice Address - Street 1:2151 W EVANS ST STE J
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4085
Practice Address - Country:US
Practice Address - Phone:843-661-5049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHTP-1065237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCHTP-1065OtherPRIVATE INSURANCE