Provider Demographics
NPI:1437703659
Name:GALLAGHER, SARAH MARIE (MHC-830)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:MARIE
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:MHC-830
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 KINOOLE ST STE 105
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2469
Mailing Address - Country:US
Mailing Address - Phone:808-896-4051
Mailing Address - Fax:
Practice Address - Street 1:32 KINOOLE ST STE 105
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2469
Practice Address - Country:US
Practice Address - Phone:808-513-2648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
HIMHC-830101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health