Individual
ERIN M. GALLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1845 FAIRMOUNT ST, WICHITA, KS 67260-0091
(316) 978-3440
Mailing address
1845 FAIRMOUNT ST, WICHITA, KS 67260-0091
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
T-LMLP 2562
KS
Other
Enumeration date
08/18/2014
Last updated
08/18/2014
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