Provider Demographics
NPI:1740738111
Name:GALLIEN, RACHEL (BA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:GALLIEN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 S COLLEGE RD
Mailing Address - Street 2:SUITE #220
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3212
Mailing Address - Country:US
Mailing Address - Phone:337-456-7880
Mailing Address - Fax:337-456-7882
Practice Address - Street 1:315 S COLLEGE RD
Practice Address - Street 2:SUITE #220
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3212
Practice Address - Country:US
Practice Address - Phone:337-456-7880
Practice Address - Fax:337-456-7882
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health