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General NPI Number Information
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NPI Number | 1679756191
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Entity Type | Individual
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Provider Name | MS. GLADYS WILES LIPPARD
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Gender | Female
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 12/06/2007
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Provider Practice Location Address
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Address Line | 123 N CENTER ST
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City | TAYLORSVILLE
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State | NC
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Zip | 28681-2119
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Country | US
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Telephone | 828-635-7371
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Fax |
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Provider Business Mailing Address
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Address Line | 141 TARRINGTON DR
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City | STATESVILLE
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State | NC
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Zip | 28625-2749
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Country | US
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Telephone | 704-876-0272
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | NBCC 219190
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | NBCC 219190
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License Number State |
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