Provider Demographics
NPI:1437200813
Name:GALLERT, MARY HELEN (MS)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:HELEN
Last Name:GALLERT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 K M WICKER MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-5070
Mailing Address - Country:US
Mailing Address - Phone:919-774-6829
Mailing Address - Fax:919-775-2327
Practice Address - Street 1:1915 K M WICKER MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-5070
Practice Address - Country:US
Practice Address - Phone:919-774-6829
Practice Address - Fax:919-775-2327
Is Sole Proprietor?:No
Enumeration Date:2007-01-14
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001692231H00000X
NC9316231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist