Provider Demographics
NPI:1083467112
Name:GALVAN, JOELLA (MA, MHC)
Entity Type:Individual
Prefix:
First Name:JOELLA
Middle Name:
Last Name:GALVAN
Suffix:
Gender:F
Credentials:MA, MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2172 W. NINE MILE ROAD
Mailing Address - Street 2:PMB #337
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32534
Mailing Address - Country:US
Mailing Address - Phone:850-255-0269
Mailing Address - Fax:850-937-7634
Practice Address - Street 1:9999 CREIGHTON
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514
Practice Address - Country:US
Practice Address - Phone:850-471-3430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH23387101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health