| Doctor Name: | LORRAINE BROWN GALLUP |
| NPI Number: | 1235388547 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.P.C. |
| License Number: | 001724 |
| Business Practice Address: | 1185 Main St Suite 1 Willimantic, CT - 062262093 |
| Business Phone Number: | 8604234279 |
| Business Fax Number: | 8604234284 |
| Mailing Address: | 1185 Main St, Suite 1 WILLIMANTIC |
| State: | CT |
| Postal Code: | 062262093 |
| Phone Number: | 8604234279 |
| Fax Number: | 8604234284 |
| NPI Enumeration Date: | 09/10/2008 |
| NPI Last Update Date: | 09/10/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 001724 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |