Healthcare Provider Details

I. General information

NPI: 1659284842
Provider Name (Legal Business Name): KIMBERLY GALLAUGHER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 WASHINGTON ST
MEDFORD MA
02155-4740
US

IV. Provider business mailing address

148 WASHINGTON ST
MEDFORD MA
02155-4740
US

V. Phone/Fax

Practice location:
  • Phone: 213-551-5959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHHABINDRA KARKI
Title or Position: OWNER
Credential:
Phone: 213-551-5959