Individual
MRS. KATHY J. GALLUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
4216 FLAGSTAFF CV, FORT WAYNE, IN 46815-4417
(260) 485-4357
Mailing address
4216 FLAGSTAFF CV, FORT WAYNE, IN 46815-4417
(260) 485-4357
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
99034355A
IN
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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