| Doctor Name: | JEFFREY S GALLUP |
| NPI Number: | 1013182914 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 61332 |
| Business Practice Address: | 1285 N Main St 101-10 Mansfield, TX - 760631510 |
| Business Phone Number: | 2149522324 |
| Business Fax Number: | |
| Mailing Address: | 1285 N Main St, 101-10 MANSFIELD |
| State: | TX |
| Postal Code: | 760631510 |
| Phone Number: | 2149522324 |
| Fax Number: | |
| NPI Enumeration Date: | 04/23/2008 |
| NPI Last Update Date: | 04/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 61332 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |