Provider Demographics
NPI:1811272446
Name:GALLAGHER, PAULA ELIZABETH (RD, LD)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:ELIZABETH
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:936 DENNISON AVE
Mailing Address - Street 2:APARTMENT A
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-5422
Mailing Address - Country:US
Mailing Address - Phone:216-276-4610
Mailing Address - Fax:
Practice Address - Street 1:3061 KINGSDALE CTR
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43221-2009
Practice Address - Country:US
Practice Address - Phone:614-538-0762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1062717133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic