Provider Demographics
NPI:1194411389
Name:GALLAGHER, ANN (ANNIE) ELIZABETH (LMFT)
Entity type:Individual
Prefix:MRS
First Name:ANN (ANNIE)
Middle Name:ELIZABETH
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7332 SPINNAKER ST
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-4676
Mailing Address - Country:US
Mailing Address - Phone:925-413-1345
Mailing Address - Fax:
Practice Address - Street 1:7332 SPINNAKER ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-4676
Practice Address - Country:US
Practice Address - Phone:925-413-1345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51719106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist