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General NPI Number Information
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NPI Number | 1215512413
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Entity Type | Organization
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Legal Business Name | GLADYS L. DUMA, LCSW P.C.
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 45 35 67TH STREET UNIT MD1
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City | WOODSIDE
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State | NY
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Zip | 11377
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Country | US
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Telephone | 646-427-8464
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Fax |
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Provider Business Mailing Address
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Address Line | 9018 107TH AVE
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City | OZONE PARK
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State | NY
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Zip | 11417-1335
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Country | US
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Telephone | 646-427-8464
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | GLADYS LUCIA DUMA
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Credential | LCSW
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Telephone | 646-427-8464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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