MEDICARE: STEPHANIE GALLEY CD

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	374J00000X	Doula

General Provider Information

NPI Number	:	1528790151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE GALLEY CD

Provider Business Mailing Address
First Line	:	12202 S MEADOW PARK CIR
Second Line	:
City	:	RIVERTON
State	:	UT
Zip	:	84065-7465
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12202 S MEADOW PARK CIR
Second Line	:
City	:	RIVERTON
State	:	UT
Zip	:	84065-7465
Country	:	US
Telephone Number	:	801-718-6401
Fax Number	:

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

Provider Enumeration Date	:	06/30/2022
Last Update Date	:	06/30/2022

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Directions to “ STEPHANIE GALLEY CD” Practice Location

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