Healthcare Provider Details

I. General information

NPI: 1699647149
Provider Name (Legal Business Name): MEREDITH ELIZABETH GALLAGHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 SOUND RD STE 200
HOLLY RIDGE NC
28445-7813
US

IV. Provider business mailing address

5331 VOLUNTEER AVE UNIT 102
WILMINGTON NC
28412-0422
US

V. Phone/Fax

Practice location:
  • Phone: 910-541-3636
  • Fax:
Mailing address:
  • Phone: 732-570-5638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number17996
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number13679
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: