Provider Demographics
NPI:1316902315
Name:GALLAGHER, JOANNE WYSS (PHD)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:WYSS
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MRS
Other - First Name:JOANNE
Other - Middle Name:WYSS
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:6609 N SCOTTSDALE RD BLDG G
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250
Mailing Address - Country:US
Mailing Address - Phone:480-265-8226
Mailing Address - Fax:480-948-9411
Practice Address - Street 1:6609 N SCOTTSDALE RD BLDG G
Practice Address - Street 2:SUITE 103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250
Practice Address - Country:US
Practice Address - Phone:480-265-8226
Practice Address - Fax:480-948-9411
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ820103T00000X, 103TC0700X
AZ0820103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist