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Individual

ELOINA SANDOVAL GALLAGHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LASAC

Contact information

Practice address
14050 N 83RD AVE STE 290, PEORIA, AZ 85381-5650
(623) 297-7973
Mailing address
14050 N 83RD AVE STE 290, PEORIA, AZ 85381-5650
(623) 297-7973

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LASAC-13318
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
072063
AZ
Enumeration date
09/21/2021
Last updated
04/23/2025
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