Provider Demographics
NPI:1396908240
Name:GALLAND, LOUIS LINWOOD (MED, LAC)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:LINWOOD
Last Name:GALLAND
Suffix:
Gender:M
Credentials:MED, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 W OSBORN RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85019-4006
Mailing Address - Country:US
Mailing Address - Phone:602-269-5328
Mailing Address - Fax:602-269-5381
Practice Address - Street 1:3640 W OSBORN RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85019-4006
Practice Address - Country:US
Practice Address - Phone:602-269-5328
Practice Address - Fax:602-269-5381
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-12478101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor