Provider Demographics
NPI:1881737583
Name:GALLWAY, PETER (MFTI)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:GALLWAY
Suffix:
Gender:M
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 92132
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93190-2132
Mailing Address - Country:US
Mailing Address - Phone:310-927-1597
Mailing Address - Fax:
Practice Address - Street 1:25 W ANAPAMU ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-5148
Practice Address - Country:US
Practice Address - Phone:805-730-7575
Practice Address - Fax:805-730-7503
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF46076106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist