Provider Demographics
NPI:1306651682
Name:GALL NEUROPSYCHOLOGY, LLC
Entity type:Organization
Organization Name:GALL NEUROPSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAITLYN GALL
Authorized Official - Middle Name:
Authorized Official - Last Name:GALL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-209-7711
Mailing Address - Street 1:1112 KING ARTHUR LN APT A
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5478
Mailing Address - Country:US
Mailing Address - Phone:502-509-6762
Mailing Address - Fax:
Practice Address - Street 1:222 E WITHERSPOON ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-6301
Practice Address - Country:US
Practice Address - Phone:502-509-6762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)