Individual
BRENNA JOE GALLAGHER
Active
Individual
BRENNA JOE GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
81392
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81392
NCTRS
MI
01
—
MI000023438
PROMETRICS
MI
Enumeration date
05/02/2019
Last updated
05/02/2019
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