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General NPI Number Information
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NPI Number | 1861451585
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Entity Type | Individual
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Provider Name | GLORIA AYALA-ST.CHARLES LMHC
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Gender | Female
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 1515 N UNIVERSITY DR SUITE 116A
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City | CORAL SPRINGS
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State | FL
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Zip | 33071-6096
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Country | US
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Telephone | 954-234-8278
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Fax | 954-255-1755
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Provider Business Mailing Address
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Address Line | 10701 NW 24TH ST
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-3668
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Country | US
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Telephone | 954-757-6882
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH5991
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License Number State | FL
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