Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MH7430 | FL |
NPI | 1003011545 |
---|---|
Provider Name | Mrs. Gloria Hanania |
First Address | Jacksonville, FL 32204-2342 |
Second Address | Jacksonville, FL 32204-2342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 08/07/2007 |