Individual
MICHELLE GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
UPSTATE MEDICAL UNIVERSITY, 750 E. ADAMS ST., SYRACUSE, NY 13210
(315) 464-3446
Mailing address
429 ROOSEVELT AVE APT 3, SYRACUSE, NY 13210-3144
(917) 685-2284
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
013537-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013537-01
LIMITED PERMIT TO PRACTICE PSYCHOLOGY IN NEW YORK STATE
NY
Enumeration date
05/28/2019
Last updated
11/27/2023
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