Provider Demographics
NPI:1851465827
Name:GALIPEAU, MARY CHARLOTTE (LMT)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:CHARLOTTE
Last Name:GALIPEAU
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:POST OFFICE BOX 76
Mailing Address - Street 2:
Mailing Address - City:THOMPSON RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10985
Mailing Address - Country:US
Mailing Address - Phone:845-733-6100
Mailing Address - Fax:845-733-6161
Practice Address - Street 1:22 NORTH ROAD
Practice Address - Street 2:
Practice Address - City:BLOOMINGBURG
Practice Address - State:NY
Practice Address - Zip Code:12721
Practice Address - Country:US
Practice Address - Phone:845-733-6100
Practice Address - Fax:845-733-6161
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010255225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist