Gallegos, Matt

Gallegos, Matt is an individual health care provider with primary practice located at 324 W Main St , Farmington NM 87401. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Gallegos, Matt can be contacted via phone (505) 772-9663.

Contact Information

Primary practice address
324 W Main St Farmington NM 87401
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1942938337
LBN Legal business name Gallegos, Matt
Credentials CPSW
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2022
Last updated Aug 12th, 2022 - about 3 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 1942938337 NPPES
New Mexico MEDICAID 1395

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