Individual
JENNIFER GALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1033 LARCHWOOD RD, MANSFIELD, OH 44907-2424
(419) 747-4126
Mailing address
729 HAMPTON DR, MANSFIELD, OH 44907-1807
(419) 612-1760
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10600000X
—
OH
Enumeration date
10/21/2019
Last updated
10/21/2019
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