Individual
DOUGLAS R GALLUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
1169 CALL CREEK,STE B, POCATELLO, ID 83201
(208) 232-7780
(208) 232-7782
Mailing address
1169 CALL CREEK, POCATELLO, ID 83201
(208) 232-7780
(208) 232-7782
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC 3309
ID
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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