Provider Demographics
NPI:1689029282
Name:GALLAGHER, PATRICIA LILLIAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LILLIAN
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 WASHINGTON ST
Mailing Address - Street 2:URI TESTING SERVICES ROOM 303
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-1819
Mailing Address - Country:US
Mailing Address - Phone:401-277-5180
Mailing Address - Fax:
Practice Address - Street 1:80 WASHINGTON ST
Practice Address - Street 2:URI TESTING SERVICES ROOM 303
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-1819
Practice Address - Country:US
Practice Address - Phone:401-277-5180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7510101YM0800X
RIPS00510101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health