Provider Demographics
NPI:1922252832
Name:GALLAGHER, KATE SARAH (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATE
Middle Name:SARAH
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229-02 KINGSBURY AVENUE
Mailing Address - Street 2:APT. A
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11364
Mailing Address - Country:US
Mailing Address - Phone:516-375-4512
Mailing Address - Fax:
Practice Address - Street 1:8237 KEW GARDENS RD
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-1618
Practice Address - Country:US
Practice Address - Phone:718-544-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012199-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist