| Gloria J Gallo, P.a. | |
|
8085 Wayzata Blvd Suite 212 Golden Valley MN 55426-1453 | |
| (763) 546-1796 | |
| Not Available |
| Full Name | Gloria J Gallo, P.a. |
|---|---|
| Speciality | Psychologist |
| Location | 8085 Wayzata Blvd, Golden Valley, Minnesota |
| Authorized Official Name and Position | Gloria Jean Gallo (LICENSED PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 7635461796 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gloria J Gallo, P.a. 8085 Wayzata Blvd Suite 212 Golden Valley MN 55426-1453 Ph: (763) 546-1796 | Gloria J Gallo, P.a. 8085 Wayzata Blvd Suite 212 Golden Valley MN 55426-1453 Ph: (763) 546-1796 |
| NPI Number | 1609885516 |
|---|---|
| Provider Enumeration Date | 08/07/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8527062538 |
|---|---|
| Medicare Enrollment ID | O20060906000295 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609885516 | NPI | - | NPPES |
| 42F69GA | Other | MN | BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP2964 (Minnesota) | Primary |
| Provider Name | Gloria J Gallo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699783381 PECOS PAC ID: 3173527181 Enrollment ID: I20060906000287 |
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