Provider Demographics
NPI:1710186648
Name:GALLOWAY, HELEN ROBERTA (LMT)
Entity type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:ROBERTA
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 DIXON BLVD
Mailing Address - Street 2:SUITE 14 A
Mailing Address - City:COCOA
Mailing Address - State:FL
Mailing Address - Zip Code:32922-6887
Mailing Address - Country:US
Mailing Address - Phone:321-636-5848
Mailing Address - Fax:
Practice Address - Street 1:817 DIXON BLVD
Practice Address - Street 2:SUITE 14 A
Practice Address - City:COCOA
Practice Address - State:FL
Practice Address - Zip Code:32922-6887
Practice Address - Country:US
Practice Address - Phone:321-636-5848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-11
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM 19702175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath