Provider Demographics
NPI:1447559422
Name:GALANG, ERIC
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:GALANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 S 460 E
Mailing Address - Street 2:
Mailing Address - City:SOUTH SALT LAKE
Mailing Address - State:UT
Mailing Address - Zip Code:84115
Mailing Address - Country:US
Mailing Address - Phone:801-631-6626
Mailing Address - Fax:
Practice Address - Street 1:3320 S 460 E
Practice Address - Street 2:
Practice Address - City:SOUTH SALT LAKE
Practice Address - State:UT
Practice Address - Zip Code:84115-4107
Practice Address - Country:US
Practice Address - Phone:801-631-6626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health