Provider Demographics
NPI:1093750515
Name:GALLAGHER, KATHRYN (MSW, LMSW, ACSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:MSW, LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 N MCKINLEY RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-1351
Mailing Address - Country:US
Mailing Address - Phone:810-257-3645
Mailing Address - Fax:810-257-0760
Practice Address - Street 1:422 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-2404
Practice Address - Country:US
Practice Address - Phone:810-257-3645
Practice Address - Fax:810-257-0760
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010688771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical