Provider Demographics
NPI:1619314713
Name:GALLAWAY, SAMANTHA LAUREN (MSW)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:LAUREN
Last Name:GALLAWAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 WOODS AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-5920
Mailing Address - Country:US
Mailing Address - Phone:323-333-4768
Mailing Address - Fax:
Practice Address - Street 1:2334 WOODS AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-5920
Practice Address - Country:US
Practice Address - Phone:323-333-4768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker