Healthcare Provider Details

I. General information

NPI: 1477097913
Provider Name (Legal Business Name): GLORIA CUDICIO-HAYDEN MS, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FITCH GLORIA

II. Dates (important events)

Enumeration Date: 12/16/2016
Last Update Date: 12/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 CENTURY DR
MECHANICSBURG PA
17055-4530
US

IV. Provider business mailing address

225 S ARLINGTON AVE
HARRISBURG PA
17109-2610
US

V. Phone/Fax

Practice location:
  • Phone: 717-795-0330
  • Fax:
Mailing address:
  • Phone: 570-899-1816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: