Most Relevant Information
Provider Data
| NPI Number: | 1003369372 |
| Provider Name: | SEAN MARSHALL GALLOWAY |
| Entity Type: | Individual |
| Taxonomy Code: | 167G00000X |
| Specialty: | Licensed Psychiatric Technician |
| License Number: | PT 40085 |
Most Important Dates
| Enumeration Date: | 08/03/2016 |
| Last Updated: | 09/07/2020 |
Provider Practice Location
2180 JOHNSON AVE
SAN LUIS OBISPO
CA
934014558
Practice Location Phone/Fax
| Phone: | 8057814275 |
| Fax: |
Provider Mailing Location
2180 JOHNSON AVE
SAN LUIS OBISPO
CA
934014558
Provider Mailing Phone/Fax
| Phone: | 8057814275 |
| Fax: |