Provider Demographics
NPI:1538303326
Name:GALLAGHER, MELISSA R (MS, CNHP)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:R
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:MS, CNHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7005 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-5909
Mailing Address - Country:US
Mailing Address - Phone:727-502-3464
Mailing Address - Fax:
Practice Address - Street 1:7005 4TH ST N
Practice Address - Street 2:SUITE 3
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702
Practice Address - Country:US
Practice Address - Phone:727-502-3464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No171W00000XOther Service ProvidersContractor
No175F00000XOther Service ProvidersNaturopath
No175L00000XOther Service ProvidersHomeopath
No226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist