Individual
DESTINY GALLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9163 W FLAMINGO RD STE 100, LAS VEGAS, NV 89147-6458
(503) 890-6173
Mailing address
41521 W 11 MILE RD, NOVI, MI 48375-1803
(248) 299-0030
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
NV
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/22/2018
Last updated
12/30/2019
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