Provider Demographics
NPI:1780665687
Name:GALLIANO, OMEGA JODEAN (MS)
Entity Type:Individual
Prefix:MS
First Name:OMEGA
Middle Name:JODEAN
Last Name:GALLIANO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9413 DREW CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7273
Mailing Address - Country:US
Mailing Address - Phone:702-258-5711
Mailing Address - Fax:702-258-1304
Practice Address - Street 1:8350 W SAHARA AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-8939
Practice Address - Country:US
Practice Address - Phone:702-258-5711
Practice Address - Fax:702-258-1304
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV619101YA0400X
MNLP0146103TC0700X
NV0551106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist