Provider Demographics
NPI:1407458649
Name:GALLEGOS, REBECCA PAMELA
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:PAMELA
Last Name:GALLEGOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:P
Other - Last Name:GALLEGOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:708 WINFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-5628
Mailing Address - Country:US
Mailing Address - Phone:419-581-0379
Mailing Address - Fax:419-424-4024
Practice Address - Street 1:708 WINFIELD AVE
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-5628
Practice Address - Country:US
Practice Address - Phone:419-581-0379
Practice Address - Fax:419-424-4024
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker