Provider Demographics
NPI:1780890103
Name:GALLUS, KAMI LYN (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:KAMI
Middle Name:LYN
Last Name:GALLUS
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 NANCY RANDOLPH DAVIS OKLAHOMA STATE UNIVERSITY
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74078-6120
Mailing Address - Country:US
Mailing Address - Phone:405-744-8351
Mailing Address - Fax:405-744-2800
Practice Address - Street 1:233 HES
Practice Address - Street 2:CENTER FOR FAMILY SERVICES
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74078-6120
Practice Address - Country:US
Practice Address - Phone:405-744-8351
Practice Address - Fax:405-744-2800
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK920106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist