Provider Demographics
NPI:1740430750
Name:GALLAGHER, LINDA ANN (MS-SLP,CCC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:MS-SLP,CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 VINEYARD AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-2332
Mailing Address - Country:US
Mailing Address - Phone:845-778-5225
Mailing Address - Fax:
Practice Address - Street 1:158 HIGH MDWS
Practice Address - Street 2:
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-2609
Practice Address - Country:US
Practice Address - Phone:845-778-5225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9034-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist