Individual
THERESA R. GARGALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LLPC
Contact information
Practice address
44 E 8TH ST, SUITE 200, HOLLAND, MI 49423-3575
(616) 510-5515
Mailing address
44 E 8TH ST, SUITE 200, HOLLAND, MI 49423-3575
(616) 510-5515
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401011392
MI
101YP2500X
Professional Counselor
6401011392
MI
102L00000X
Psychoanalyst
6401011392
MI
Other
Enumeration date
07/09/2009
Last updated
07/09/2009
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