Healthcare Provider Details

I. General information

NPI: 1538766027
Provider Name (Legal Business Name): MS. TAYLOR GALLAGHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3518 W 25TH ST
CLEVELAND OH
44109-1951
US

IV. Provider business mailing address

4813 COLUMBIA RD APT 104
NORTH OLMSTED OH
44070-3611
US

V. Phone/Fax

Practice location:
  • Phone: 440-219-7905
  • Fax:
Mailing address:
  • Phone: 440-219-7905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: