Provider Demographics
NPI:1437345584
Name:GALLAGHER, SARAH W (RD)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:W
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3447 HANNIBAL ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-4523
Mailing Address - Country:US
Mailing Address - Phone:406-494-0199
Mailing Address - Fax:
Practice Address - Street 1:3447 HANNIBAL ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-4523
Practice Address - Country:US
Practice Address - Phone:406-494-0199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-22
Last Update Date:2007-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT725030133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered