MEDICARE: SALLY GALLAGHER LINDSAY MS CCC-SLP

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	235Z00000X	Speech-Language Pathologist	4939	NC

General Provider Information

NPI Number	:	1740168152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALLY GALLAGHER LINDSAY MS CCC-SLP

Provider Business Mailing Address
First Line	:	501 S SHARON AMITY RD STE 350
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-3099
Country	:	US
Telephone Number	:	704-458-9019
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 S SHARON AMITY RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-2896
Country	:	US
Telephone Number	:	704-458-9019
Fax Number	:

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

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/25/2025

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