MEDICARE: WILLIAM KEITH GALER MS, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MT2108	FL

General Provider Information

NPI Number	:	1144562000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM KEITH GALER MS, LMFT

Provider Business Mailing Address
First Line	:	1102 A1A N STE 203
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32082-4098
Country	:	US
Telephone Number	:	904-569-6875
Fax Number	:	904-833-3373

Provider Business Practice Location Address
First Line	:	1102 A1A N STE 203
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32082-4098
Country	:	US
Telephone Number	:	904-569-6875
Fax Number	:	904-833-3373

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2013
Last Update Date	:	12/26/2023

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