Provider Demographics
NPI:1912684796
Name:GALLIANI, SONJA LEIGH (LPC-A, RD, LD)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:LEIGH
Last Name:GALLIANI
Suffix:
Gender:F
Credentials:LPC-A, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 SAGE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-1417
Mailing Address - Country:US
Mailing Address - Phone:210-651-2693
Mailing Address - Fax:
Practice Address - Street 1:107 SAGE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-1417
Practice Address - Country:US
Practice Address - Phone:210-651-2693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86209777133VN1006X
TX91077101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic