Healthcare Provider Details

I. General information

NPI: 1548107345
Provider Name (Legal Business Name): MARCI GALLAGHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 W CLINTON ST
GRAY GA
31032-5301
US

IV. Provider business mailing address

PO BOX 818
GRAY GA
31032-0818
US

V. Phone/Fax

Practice location:
  • Phone: 217-246-6693
  • Fax:
Mailing address:
  • Phone: 478-216-8147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: