Individual
MELISSA NATALIE GALLEGOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1531 DOUGLAS ST, OGDEN, UT 84404-6830
(801) 645-1764
Mailing address
1531 DOUGLAS ST, OGDEN, UT 84404-6830
(801) 645-1764
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6692212-3506
UT
1041C0700X
Clinical Social Worker
Primary
6692212-3501
UT
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
260022408
RAILROAD MEDICARE
UT
05
—
876000308007
—
UT
Enumeration date
08/22/2007
Last updated
12/18/2023
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