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Individual

DR. JODY A GALLAWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
1011 N 8TH ST, SHEBOYGAN, WI 53081-4006
(920) 459-3155
(920) 459-4353
Mailing address
1011 N 8TH ST, SHEBOYGAN, WI 53081-4006
(920) 459-3207
(920) 459-4353

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
103TC0700X
Clinical Psychologist
Primary
2319-057
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
39134800
WI
Enumeration date
05/15/2006
Last updated
12/14/2020
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