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Contact Information

MELISSA A GALLUP
HWY 264 MPP 388
POLACCA, AZ86042
 Phone: 928-737-6187
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for MELISSA A GALLUP · (Female)

NPI # 1497265953
Status Active
Credentials
Entity Individual
Enumeration date 10/10/2017
Last updated 10/21/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 099082
  • SD License # 4947
  • NY Medicaid 1497265953
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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