Provider Demographics
NPI:1386693844
Name:GAL ENDRES, LINDA M (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:M
Last Name:GAL ENDRES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:M
Other - Last Name:ENDRES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2460 HAWTHORNE WAY
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1665
Mailing Address - Country:US
Mailing Address - Phone:513-290-8988
Mailing Address - Fax:
Practice Address - Street 1:2460 HAWTHORNE WAY
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1665
Practice Address - Country:US
Practice Address - Phone:513-290-8988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015675103TC0700X
OH6113103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical