Healthcare Provider Details
I. General information
NPI: 1487534848
Provider Name (Legal Business Name): BETHANY GALLAGHER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/05/2025
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7103 SHEFFIELD RD
BALTIMORE MD
21212-1628
US
IV. Provider business mailing address
7103 SHEFFIELD RD
BALTIMORE MD
21212-1628
US
V. Phone/Fax
- Phone: 412-445-8824
- Fax:
- Phone: 412-445-8824
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WL0100X |
| Taxonomy | Lactation Consultant (Registered Nurse) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BETHANY
GALLAGHER
Title or Position: LACTATION COUNSELOR/SPEECH PATHOLOG
Credential: CCC-SLP, IBCLC
Phone: 412-445-8825