Healthcare Provider Details
I. General information
NPI: 1750168050
Provider Name (Legal Business Name): NOELLE GALARDI CSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/11/2023
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4233 SE 182ND AVE # 212
GRESHAM OR
97030-5082
US
IV. Provider business mailing address
4233 SE 182ND AVE # 212
GRESHAM OR
97030-5082
US
V. Phone/Fax
- Phone: 971-220-2496
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | A15575 |
| License Number State | OR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: