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NPI Code Detail

MEDICARE: LEAH RENEE GALLO

MEDICARE: LEAH RENEE GALLO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-22-61263IN
2106S00000XBehavior TechnicianRBT-17-34404IN

General Provider Information

NPI Number : 1568081065
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH RENEE GALLO
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8409 MERRILLVILLE RD
Second Line :
City : MERRILLVILLE
State : IN
Zip : 46410-6109
Country : US
Telephone Number : 219-205-3463
Fax Number : 317-520-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2020
Last Update Date : 12/03/2025

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Directions to “ LEAH RENEE GALLO ” Practice Location

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