Provider Demographics
NPI:1649587312
Name:GALLAGHER, HELEN S (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:S
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HALFWAY POINT RD
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04943-3043
Mailing Address - Country:US
Mailing Address - Phone:207-938-4703
Mailing Address - Fax:
Practice Address - Street 1:170 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:ME
Practice Address - Zip Code:04967-4745
Practice Address - Country:US
Practice Address - Phone:207-487-5575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP311235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist