Healthcare Provider Details
I. General information
NPI: 1972760072
Provider Name (Legal Business Name): RICHARD G GALE, JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/18/2008
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
171 CHARRING CROSS DR S
WESTERVILLE OH
43081-2862
US
IV. Provider business mailing address
171 CHARRING CROSS DR S
WESTERVILLE OH
43081-2862
US
V. Phone/Fax
- Phone: 614-890-8262
- Fax: 614-776-5333
- Phone: 614-890-8262
- Fax: 614-776-5333
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | E. 1200006 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: