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General NPI Number Information
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NPI Number | 1093988172
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Entity Type | Organization
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Legal Business Name | GALLO & ASSOCIATES PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 60 SNYDER RD
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City | HERMITAGE
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State | PA
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Zip | 16148-3432
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Country | US
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Telephone | 724-346-3838
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Fax | 724-346-4339
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Provider Business Mailing Address
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Address Line | 60 SNYDER RD
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City | HERMITAGE
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State | PA
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Zip | 16148-3432
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Country | US
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Telephone | 724-346-3838
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Fax | 724-346-4339
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST/OWNER
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Name | DR. FRED P GALLO
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Credential | PH.D.
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Telephone | 724-346-3838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS002468L
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License Number State | PA
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