Provider Demographics
NPI:1215722145
Name:GALLIERS, AMY MARIA
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MARIA
Last Name:GALLIERS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 S SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:MI
Mailing Address - Zip Code:49036-7748
Mailing Address - Country:US
Mailing Address - Phone:517-795-6716
Mailing Address - Fax:
Practice Address - Street 1:694 W CHICAGO RD
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MI
Practice Address - Zip Code:49036-8405
Practice Address - Country:US
Practice Address - Phone:517-279-8866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511197391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical