| NPI | 1700970969 |
|---|---|
| Former Name | GLORIA JEAN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |