Individual
JASON E GALLAHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC, LMT,
Contact information
Practice address
2945 CENTER GREEN CT STE H, BOULDER, CO 80301-2275
(419) 351-2824
Mailing address
3100 PEARL PKWY APT 112, BOULDER, CO 80301-2412
(419) 351-2824
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPCC.0015846
CO
225700000X
Massage Therapist
MT.0020930
CO
Other
Enumeration date
01/25/2018
Last updated
06/20/2018
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