Provider Demographics
NPI:1700374691
Name:GALBRAITH, DRU
Entity Type:Individual
Prefix:MR
First Name:DRU
Middle Name:
Last Name:GALBRAITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 CAMINO TETZCOCO
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-8913
Mailing Address - Country:US
Mailing Address - Phone:505-216-5161
Mailing Address - Fax:
Practice Address - Street 1:28 CAMINO TETZCOCO
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-8913
Practice Address - Country:US
Practice Address - Phone:505-216-5161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician