| Doctor Name: | MARYELLEN GALLAGHER |
| NPI Number: | 1356713085 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS CCC SLP |
| License Number: | 144.0116056 |
| Business Practice Address: | 790 College Pkwy Colchester, VT - 054463007 |
| Business Phone Number: | 8028473940 |
| Business Fax Number: | |
| Mailing Address: | 1195 North Ave, Apt 304 BURLINGTON |
| State: | VT |
| Postal Code: | 054082812 |
| Phone Number: | 2072339611 |
| Fax Number: | |
| NPI Enumeration Date: | 10/21/2015 |
| NPI Last Update Date: | 10/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 144.0116056 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |