Doctor Name: | GREGORY R PALLAY |
NPI Number: | 1689600025 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC , LMFT |
License Number: | 2557 |
Business Practice Address: | 6240 Greenwood Rd Shreveport, LA - 711198413 |
Business Phone Number: | 3186322010 |
Business Fax Number: | 3186322055 |
Mailing Address: | 6240 Greenwood Rd, SHREVEPORT |
State: | LA |
Postal Code: | 711198413 |
Phone Number: | 3186322010 |
Fax Number: | 3186322055 |
NPI Enumeration Date: | 06/25/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2557 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |