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General NPI Number Information
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NPI Number | 1891323663
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Entity Type | Individual
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Provider Name | DANIEL GALBO
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Gender | Male
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Dates
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Enumeration Date | 03/29/2020
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 111 N MAIN ST STE 100
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City | JANESVILLE
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State | WI
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Zip | 53545-3072
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Country | US
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Telephone | 608-580-0031
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Fax |
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Provider Business Mailing Address
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Address Line | 2122 PARK CREST DR
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City | FREEPORT
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State | IL
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Zip | 61032-3553
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Country | US
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Telephone | 312-801-5964
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071.010172
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 5334-57
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License Number State | WI
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