Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1053776278 |
---|---|
Provider Name | Meillanny Gladness |
First Address | Laguna Hills, CA 92653-1343 |
Second Address | Laguna Hills, CA 92653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2015 |
Last Update Date | 27/09/2019 |