Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | SIO3154 | NJ |
NPI | 1073537163 |
---|---|
Provider Name | Dr. Abisola Helen Gallagher |
First Address | Montclair, NJ 07042 |
Second Address | Montclair, NJ 07042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 01/05/2018 |