Provider Demographics
NPI:1407066616
Name:GALLAGHER, JOAN H (LSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:H
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8337 HIGH SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2027
Mailing Address - Country:US
Mailing Address - Phone:215-771-0796
Mailing Address - Fax:
Practice Address - Street 1:315 YORKTOWN PLZ
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1427
Practice Address - Country:US
Practice Address - Phone:215-771-0796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW006089E104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker