Provider Demographics
NPI:1285840611
Name:GALVAN, CAROL A (MFT)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:A
Last Name:GALVAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3486 TWENTY MILE WAY
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-3202
Mailing Address - Country:US
Mailing Address - Phone:513-583-0995
Mailing Address - Fax:513-583-0996
Practice Address - Street 1:3486 TWENTY MILE WAY
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-3202
Practice Address - Country:US
Practice Address - Phone:513-583-0995
Practice Address - Fax:513-583-0996
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF077106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist