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General NPI Number Information
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NPI Number | 1073307278
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Entity Type | Individual
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Provider Name | GLADYS M DOGGETT MSSW, CSW
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Gender | Female
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Dates
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Enumeration Date | 04/04/2025
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 1028 BARRET AVE
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City | LOUISVILLE
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State | KY
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Zip | 40204-1667
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Country | US
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Telephone | 502-451-1221
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Fax | 502-451-1337
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Provider Business Mailing Address
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Address Line | 1028 BARRET AVE
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City | LOUISVILLE
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State | KY
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Zip | 40204-1667
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Country | US
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Telephone | 502-451-1221
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Fax | 502-451-1337
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 259405
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License Number State | KY
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