Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 018024 | NY |
Y | 103G00000X | Clinical Psychologist | 018024 | NY |
Y | 103TC0700X | Clinical Psychologist | 018024 | NY |
NPI | 1164753471 |
---|---|
Provider Name | Dr. Laurie Anne Gallo |
First Address | White Plains, NY 10607-1534 |
Second Address | Bronx, NY 10467-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2010 |
Last Update Date | 26/01/2010 |