Gallaher, Richard Ballou

Gallaher, Richard Ballou is an individual health care provider with primary practice located at 513 Thain Road , Lewiston ID 83501-4140. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Gallaher, Richard Ballou can be contacted via phone (208) 743-0150.

Contact Information

Primary practice address
513 Thain Road Lewiston ID 83501-4140
Phone: (208) 743-0150
Fax: (208) 743-5358
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY-202154 Idaho
Behavioral Health & Social Service Providers / Psychologist 103T00000X PY00000815 Washington

Profile Details

NPI number 1376634345
LBN Legal business name Gallaher, Richard Ballou
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2006
Last updated Jan 8th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376634345 NPPES
Idaho Other 000010147148 REGENCE BLUESHIELD
Idaho MEDICAID 041256289 REGENCE BLUESHIELD
Idaho Other 550867358 REGENCE BLUESHIELD
Idaho Other Y0929 REGENCE BLUESHIELD
Idaho MEDICAID 806984800 REGENCE BLUESHIELD

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