Healthcare Provider Details

I. General information

NPI: 1558899096
Provider Name (Legal Business Name): DEBBIE GALLETTA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2017
Last Update Date: 05/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1163 WASHINGTON ST
TOMS RIVER NJ
08753-6833
US

IV. Provider business mailing address

2820 INVERNESS DR
TOMS RIVER NJ
08753-6318
US

V. Phone/Fax

Practice location:
  • Phone: 732-330-8078
  • Fax:
Mailing address:
  • Phone: 732-330-8078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number44SC05616800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: