Individual
ADA GALLUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLPC
Contact information
Practice address
409 VANDIVER DR STE 102, COLUMBIA, MO 65202-3754
(573) 239-6642
Mailing address
409 VANDIVER DR, BUILDING 4, SUITE 102, COLUMBIA, MO 65202-3754
(573) 239-6642
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2016008293
MO
Other
Enumeration date
03/28/2016
Last updated
03/17/2018
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