Provider Demographics
NPI:1639737638
Name:GALLOZZI, SHARAYA (LMFT)
Entity Type:Individual
Prefix:
First Name:SHARAYA
Middle Name:
Last Name:GALLOZZI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4907 S COLLINS ST STE 121
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1157
Mailing Address - Country:US
Mailing Address - Phone:817-900-0453
Mailing Address - Fax:
Practice Address - Street 1:4907 S COLLINS ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1156
Practice Address - Country:US
Practice Address - Phone:817-900-0453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-04
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203049106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty