Individual
BRANDIE JOHWAN GALLIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
124 ABIGAYLE ROW, SCOTT, LA 70583-8909
(337) 326-4567
Mailing address
124 ABIGAYLE ROW, SCOTT, LA 70583-8909
(337) 326-4567
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000
—
LA
Enumeration date
10/01/2019
Last updated
06/23/2020
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