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Individual
MRS. MARY ELLEN GALLAGHER
Active
Individual
MRS. MARY ELLEN GALLAGHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0034794
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0034794
NYS LICENSE# NY STATE ED DEPT/DIV. OF PROF LICENSE
NY
01
—
400101
AOTA# AM-OCCUPATIONAL THERAPY ASSOC
—
Enumeration date
10/18/2012
Last updated
10/18/2012
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