Provider Demographics
NPI:1104072743
Name:GALLOPS, KATHLEEN GILLIAM (OTR/L)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:GILLIAM
Last Name:GALLOPS
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 1:705 17TH ST
Mailing Address - Street 2:SUITE 407
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-3500
Mailing Address - Country:US
Mailing Address - Phone:706-321-0930
Mailing Address - Fax:
Practice Address - Street 1:705 17TH ST
Practice Address - Street 2:SUITE 407
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3500
Practice Address - Country:US
Practice Address - Phone:706-321-0930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT004695225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist