Individual
LOLY GALLEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
402 E MAIN ST, WATERBURY, CT 06702-1701
(203) 755-1143
(203) 753-3274
Mailing address
141 E MAIN ST, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
104100000X
Social Worker
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/08/2017
Last updated
12/21/2023
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