Provider Demographics
NPI:1992858302
Name:GALVAN, NALLELY (MS)
Entity Type:Individual
Prefix:MISS
First Name:NALLELY
Middle Name:
Last Name:GALVAN
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 1:204 W WASHINGTON ST
Mailing Address - Street 2:APT. 15
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-4149
Mailing Address - Country:US
Mailing Address - Phone:217-328-1273
Mailing Address - Fax:
Practice Address - Street 1:1801 FOX DR
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-7236
Practice Address - Country:US
Practice Address - Phone:217-398-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health