Provider Demographics
NPI:1073950127
Name:GALLO, VANESSA (PE)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:GALLO
Suffix:
Gender:F
Credentials:PE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 S MCCARRAN BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-9513
Mailing Address - Country:US
Mailing Address - Phone:775-954-1400
Mailing Address - Fax:775-954-1406
Practice Address - Street 1:1725 S MCCARRAN BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-9513
Practice Address - Country:US
Practice Address - Phone:775-954-1400
Practice Address - Fax:775-954-1406
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator