Provider Demographics
NPI:1720387533
Name:GALVIN, ERMA J (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ERMA
Middle Name:J
Last Name:GALVIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WEST CHURCH STREET
Mailing Address - Street 2:PO BOX 189
Mailing Address - City:HEBRON
Mailing Address - State:IN
Mailing Address - Zip Code:46341
Mailing Address - Country:US
Mailing Address - Phone:219-743-7978
Mailing Address - Fax:
Practice Address - Street 1:104 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:IN
Practice Address - Zip Code:46341-8558
Practice Address - Country:US
Practice Address - Phone:219-743-7978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker