Doctor Name: | MELISSA SUE GALLARDO |
NPI Number: | 1700981305 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | AA |
License Number: | |
Business Practice Address: | 441 No Main St Alturas, CA - 96101 |
Business Phone Number: | 5302336319 |
Business Fax Number: | 5302335311 |
Mailing Address: | Hc4 Box 49024, ALTURAS |
State: | CA |
Postal Code: | 96101 |
Phone Number: | 5302334577 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |