Individual
MRS. AMANDA JO GALLAHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
250 LAKEWOOD CTR, MORGANTOWN, WV 26508-4457
(304) 825-1656
(304) 825-1657
Mailing address
RT 3 BOX 459, GRAFTON, WV 26354
(304) 825-1656
(304) 825-1657
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0727
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9409224000
—
WV
Enumeration date
02/14/2008
Last updated
02/04/2012
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