Individual
MICHAEL THOMAS GALLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
1100 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1909
(570) 320-7525
(570) 320-7484
Mailing address
1201 GRAMPIAN BLVD, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MF000132
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020092310001
—
PA
01
—
817809
FIRST PRIORITY HEALTH
PA
Enumeration date
04/03/2006
Last updated
02/10/2016
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