Provider Demographics
NPI:1982377826
Name:GALLAGHER, MOLLY GABRIELLE (IBCLC)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:GABRIELLE
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 WILDFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-3459
Mailing Address - Country:US
Mailing Address - Phone:707-526-3136
Mailing Address - Fax:
Practice Address - Street 1:211 WILDFLOWER DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-3459
Practice Address - Country:US
Practice Address - Phone:707-526-3136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-303492174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN