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General NPI Number Information
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NPI Number | 1457107823
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Entity Type | Individual
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Provider Name | ANDREA RODRIGUEZ-GALLO MS, LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 04/26/2024
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 36 EUCLID ST
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City | WOODBURY
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State | NJ
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Zip | 08096-4626
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Country | US
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Telephone | 856-436-0035
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Fax |
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Provider Business Mailing Address
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Address Line | 22 N BROAD ST
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City | WOODBURY
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State | NJ
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Zip | 08096-4603
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Country | US
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Telephone | 856-436-0035
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 37PC01173300
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License Number State | NJ
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