Individual
HALEIGH GALLEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 492-0241
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
THW000004116
OR
Other
Enumeration date
02/19/2019
Last updated
02/24/2020
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