Healthcare Provider Details

I. General information

NPI: 1255242145
Provider Name (Legal Business Name): ZENDA GALLOWAY ADT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 WHALER CT
GLEN BURNIE MD
21061-9507
US

IV. Provider business mailing address

7520 WHALER CT
GLEN BURNIE MD
21061-9507
US

V. Phone/Fax

Practice location:
  • Phone: 443-333-3150
  • Fax:
Mailing address:
  • Phone: 443-333-3150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberADT4150
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: