Provider Demographics
NPI:1609375526
Name:GALLAGHER, KELSEY
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:GALLAGHER
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 1:148 KOEHLER HILL RD
Mailing Address - Street 2:
Mailing Address - City:SCOTT TWP
Mailing Address - State:PA
Mailing Address - Zip Code:18447-7654
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:148 KOEHLER HILL RD
Practice Address - Street 2:
Practice Address - City:SCOTT TWP
Practice Address - State:PA
Practice Address - Zip Code:18447-7654
Practice Address - Country:US
Practice Address - Phone:570-878-7501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist