Provider Demographics
NPI:1376889261
Name:GALLAGHER, LORETTA ANN (MSCCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:ANN
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 CENTRAL DR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-4410
Mailing Address - Country:US
Mailing Address - Phone:412-862-9185
Mailing Address - Fax:
Practice Address - Street 1:342 CENTRAL DR
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-4410
Practice Address - Country:US
Practice Address - Phone:412-862-9185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-20
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009342235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist