Individual
KELLSY TERESA GALLUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LPC
Contact information
Practice address
924 S DAVIS ST, JEROME, ID 83338-3250
(208) 490-6788
Mailing address
924 S DAVIS ST, JEROME, ID 83338-3250
(208) 490-6788
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1571861
ID
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
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