Individual
GARY M GALLITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
10500 N PORT WASHINGTON RD, MEQUON, WI 53092-5585
(262) 240-0427
(262) 240-0429
Mailing address
10137 W RIDGE RD, HALES CORNERS, WI 53130-1435
(262) 337-0255
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3830-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3830-125
LICENSE
WI
Enumeration date
02/18/2008
Last updated
02/18/2008
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