Provider Demographics
NPI:1750197026
Name:GALLAGHER, DANIELLE JEANY
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:JEANY
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 SONORA NOLIN RD
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:KY
Mailing Address - Zip Code:42776-9352
Mailing Address - Country:US
Mailing Address - Phone:270-996-2599
Mailing Address - Fax:
Practice Address - Street 1:970 BLOOMFIELD RD
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-9708
Practice Address - Country:US
Practice Address - Phone:502-234-7800
Practice Address - Fax:502-470-7432
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY258086104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty