Individual
AUDRA JEAN GALLOGLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1120 W SOUTH BOULDER RD STE 101B, LAFAYETTE, CO 80026-8952
(303) 389-2793
Mailing address
1915 LARSON CT, ERIE, CO 80516-7578
(303) 669-4132
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00992163
CO
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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