Provider Demographics
NPI:1881819167
Name:DANIELS-GALLETTI, ANITA E (LIC AC)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:E
Last Name:DANIELS-GALLETTI
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 854
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02362-0854
Mailing Address - Country:US
Mailing Address - Phone:617-688-2728
Mailing Address - Fax:
Practice Address - Street 1:34 LONG POND RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2606
Practice Address - Country:US
Practice Address - Phone:617-688-2728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223826171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist