MEDICARE: GERIANNE GALLAGHER MSW

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	104100000X	Social Worker	SW128222	PA

General Provider Information

NPI Number	:	1891125498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERIANNE GALLAGHER MSW

Provider Business Mailing Address
First Line	:	1101 SW EMBERS TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-1509
Country	:	US
Telephone Number	:	267-463-3553
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 SW EMBERS TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-1509
Country	:	US
Telephone Number	:	267-463-3553
Fax Number	:

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

Provider Enumeration Date	:	11/18/2013
Last Update Date	:	11/18/2013

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