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General NPI Number Information
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NPI Number | 1386416949
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Entity Type | Individual
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Provider Name | MARIA MACARENA GALLARDO LMFTA
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Gender | Female
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Dates
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Enumeration Date | 10/26/2023
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 8201 ARROWRIDGE BLVD STE 148
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City | CHARLOTTE
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State | NC
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Zip | 28273-5865
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Country | US
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Telephone | 704-408-8489
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Fax | 855-532-2779
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Provider Business Mailing Address
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Address Line | 1191 HENSLEY RD W
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City | FORT MILL
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State | SC
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Zip | 29715-9004
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Country | US
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Telephone | 704-408-8489
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Fax | 855-532-2779
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 10209A
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License Number State | NC
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