Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003142779 |
---|---|
Provider Name | Lauren Marie Gallison |
First Address | Greensboro, NC 27409-3409 |
Second Address | Asheboro, NC 27203-6760 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2009 |
Last Update Date | 06/04/2011 |