Provider Demographics
NPI:1255671301
Name:GALUSKA, TAMMY RENEE (PHD, BCBA)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:RENEE
Last Name:GALUSKA
Suffix:
Gender:F
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1964 ASHLEY RIVER RD STE B
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4782
Mailing Address - Country:US
Mailing Address - Phone:843-725-9624
Mailing Address - Fax:
Practice Address - Street 1:1964 ASHLEY RIVER RD STE B
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4782
Practice Address - Country:US
Practice Address - Phone:843-725-9624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1-13-12825103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst