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63484 Lightning Rd Coos Bay OR 97420-3896 | |
| (858) 878-2176 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 63484 Lightning Rd, Coos Bay, Oregon |
| Authorized Official Name and Position | Amanda Banks Galer (PROVIDER) |
| Authorized Official Contact | 8598782176 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
63484 Lightning Rd Coos Bay OR 97420-3896 Ph: (858) 878-2176 | 63484 Lightning Rd Coos Bay OR 97420-3896 Ph: (858) 878-2176 |
| NPI Number | 1023481447 |
|---|---|
| Provider Enumeration Date | 11/06/2015 |
| Last Update Date | 04/22/2024 |
| Certification Date | 04/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023481447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 3773 (Kentucky) | Primary |
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