Provider Demographics
NPI:1710225974
Name:GALLAGHER, SHEREE N (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHEREE
Middle Name:N
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 WESTERN PL
Mailing Address - Street 2:SUITE 540
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-4600
Mailing Address - Country:US
Mailing Address - Phone:817-334-0011
Mailing Address - Fax:817-334-0603
Practice Address - Street 1:6100 WESTERN PL
Practice Address - Street 2:SUITE 540
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-4600
Practice Address - Country:US
Practice Address - Phone:817-334-0011
Practice Address - Fax:817-334-0603
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15737103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical