Provider Demographics
NPI:1295222800
Name:GALEY, MADELINE RAE (MOT, OTR)
Entity Type:Individual
Prefix:MS
First Name:MADELINE
Middle Name:RAE
Last Name:GALEY
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:
Other - Last Name:WITZEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6740 DAVIDSON ST APT 415
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-5938
Mailing Address - Country:US
Mailing Address - Phone:713-857-1302
Mailing Address - Fax:
Practice Address - Street 1:1601 N COLLINS BLVD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3520
Practice Address - Country:US
Practice Address - Phone:972-497-8384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119089225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist