Provider Demographics
NPI:1194833871
Name:GALLERY, JOYCE ANN (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:ANN
Last Name:GALLERY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 BOETTGER RD
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-2011
Mailing Address - Country:US
Mailing Address - Phone:507-354-7464
Mailing Address - Fax:
Practice Address - Street 1:1725 BOETTGER RD
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-2011
Practice Address - Country:US
Practice Address - Phone:507-354-7464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN110471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN508672Medicare UPIN