Provider Demographics
NPI:1841841012
Name:CHOOKOLINGO, GALANA TENNILLE (PHD)
Entity type:Individual
Prefix:DR
First Name:GALANA
Middle Name:TENNILLE
Last Name:CHOOKOLINGO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1123 ILEAGNES RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-2378
Mailing Address - Country:US
Mailing Address - Phone:510-424-5607
Mailing Address - Fax:
Practice Address - Street 1:1123 ILEAGNES RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-2378
Practice Address - Country:US
Practice Address - Phone:510-424-5607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007484101YP2500X
CA30181103TC1900X
NC5377103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional