Provider Demographics
NPI:1740612704
Name:GALA, JINAL (MS CFY-SLP)
Entity Type:Individual
Prefix:
First Name:JINAL
Middle Name:
Last Name:GALA
Suffix:
Gender:F
Credentials:MS CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1613 W WOODS DR
Mailing Address - Street 2:APT # 407
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-8061
Mailing Address - Country:US
Mailing Address - Phone:585-748-4905
Mailing Address - Fax:
Practice Address - Street 1:800 N MARKET ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IL
Practice Address - Zip Code:61448-1096
Practice Address - Country:US
Practice Address - Phone:309-289-2027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist