Individual
DR. SHIRLEY ANNE GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.D.
Contact information
Practice address
6100 NEWPORT RD, SUITE 222, PORTAGE, MI 49002-9235
(269) 324-1248
(269) 324-1263
Mailing address
6100 NEWPORT RD, SUITE 222, PORTAGE, MI 49002-9235
(269) 324-1248
(269) 324-1263
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301003211
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680C94595
BLUE CROSS BLUE SHIELD
MI
Enumeration date
09/27/2006
Last updated
07/08/2007
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