Provider Demographics
NPI:1063094233
Name:GALLAGHER, HOPE YVONNE (OTR/L)
Entity type:Individual
Prefix:
First Name:HOPE
Middle Name:YVONNE
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 CANAAN MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:FALLS VILLAGE
Mailing Address - State:CT
Mailing Address - Zip Code:06031-1516
Mailing Address - Country:US
Mailing Address - Phone:860-671-8822
Mailing Address - Fax:
Practice Address - Street 1:17 COBBLE RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:CT
Practice Address - Zip Code:06068-1501
Practice Address - Country:US
Practice Address - Phone:860-435-9851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5415225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist