| Doctor Name: | AMBER GALLAHER-KOCH |
| NPI Number: | 1821457904 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS LPC |
| License Number: | 178.011544 |
| Business Practice Address: | 121 E 2nd St Beardstown, IL - 626181263 |
| Business Phone Number: | 2173232980 |
| Business Fax Number: | 2173233731 |
| Mailing Address: | 121 E 2nd St, BEARDSTOWN |
| State: | IL |
| Postal Code: | 626181263 |
| Phone Number: | 2173232980 |
| Fax Number: | 2173233731 |
| NPI Enumeration Date: | 02/17/2016 |
| NPI Last Update Date: | 02/17/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 178.011544 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |