Individual
KELLY GALLAGHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3218 TITANIC DR, STAFFORD, VA 22554-2627
(203) 461-5151
Mailing address
3218 TITANIC DR, STAFFORD, VA 22554-2627
(203) 461-5151
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
0701013670
VA
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
10/12/2022
Last updated
12/05/2024
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