| Doctor Name: | THEA GALLAGHER |
| NPI Number: | 1003153511 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., M.S., LPC |
| License Number: | PC006687 |
| Business Practice Address: | 22 S State St Newtown, PA - 189403507 |
| Business Phone Number: | 2155794116 |
| Business Fax Number: | |
| Mailing Address: | 247 Summit Ave, LANGHORNE |
| State: | PA |
| Postal Code: | 190472215 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/04/2013 |
| NPI Last Update Date: | 01/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC006687 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |