Individual
MARY GALLEGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2844 COLOMA ST, PLACERVILLE, CA 95667-4406
(530) 626-8992
(530) 626-8992
Mailing address
PO BOX 1666, PLACERVILLE, CA 95667-1666
(530) 626-8992
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
CA
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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