Provider Demographics
NPI:1902934656
Name:GALLIAN, MENDY LEE (MS)
Entity Type:Individual
Prefix:MISS
First Name:MENDY
Middle Name:LEE
Last Name:GALLIAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 HOLLY LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464
Mailing Address - Country:US
Mailing Address - Phone:931-332-2971
Mailing Address - Fax:
Practice Address - Street 1:1090 OLD FLORENCE RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-8401
Practice Address - Country:US
Practice Address - Phone:931-762-6505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional