Provider Demographics
NPI:1609176429
Name:GALLOWAY, KIMBERLY J
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:J
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 HOUSTON OAKS DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-2704
Mailing Address - Country:US
Mailing Address - Phone:606-584-1169
Mailing Address - Fax:855-584-7323
Practice Address - Street 1:436 HOUSTON OAKS DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2704
Practice Address - Country:US
Practice Address - Phone:606-584-1169
Practice Address - Fax:855-584-7323
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist