Provider Demographics
NPI:1073537163
Name:GALLAGHER, ABISOLA HELEN (EDD)
Entity Type:Individual
Prefix:DR
First Name:ABISOLA
Middle Name:HELEN
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:DR
Other - First Name:ABISOLA
Other - Middle Name:HELEN
Other - Last Name:GALLAGHER-HOBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDD
Mailing Address - Street 1:50 CHURCH STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042
Mailing Address - Country:US
Mailing Address - Phone:973-783-3870
Mailing Address - Fax:201-200-2558
Practice Address - Street 1:50 CHURCH STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042
Practice Address - Country:US
Practice Address - Phone:973-783-3870
Practice Address - Fax:201-200-2558
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSIO3154103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling