Healthcare Provider Details
I. General information
NPI: 1366134736
Provider Name (Legal Business Name): JALINA GALLAGHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/24/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
397 LITTLE NECK RD STE 1
VA BEACH VA
23452-5765
US
IV. Provider business mailing address
361 CLEVELAND PL STE 100
VA BEACH VA
23462-6545
US
V. Phone/Fax
- Phone: 757-222-2230
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251P0200X |
| Taxonomy | Pediatric Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: