Provider Demographics
NPI:1932430253
Name:GALLIGANI, JENNA (MS)
Entity type:Individual
Prefix:MS
First Name:JENNA
Middle Name:
Last Name:GALLIGANI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:METZGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:206 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018
Mailing Address - Country:US
Mailing Address - Phone:610-217-8789
Mailing Address - Fax:
Practice Address - Street 1:206 W BROAD ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018
Practice Address - Country:US
Practice Address - Phone:610-217-8789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PAPC007306101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health