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NPI Code Detail

MEDICARE: DR. GLORIA MARTA WORKMAN PHD

MEDICARE: DR. GLORIA MARTA WORKMAN PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist071005035IL
2103T00000XPsychologist2362TN

General Provider Information

NPI Number : 1013221175
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GLORIA MARTA WORKMAN PHD
Provider Business Mailing Address
First Line : 690 BARNES BLVD
Second Line :
City : JOINT BASE LEWIS MCCHORD
State : WA
Zip : 98438-1303
Country : US
Telephone Number : 253-982-3685
Fax Number : 253-982-9037
Provider Business Practice Location Address
First Line : 690 BARNES BLVD
Second Line :
City : JOINT BASE LEWIS MCCHORD
State : WA
Zip : 98438-1303
Country : US
Telephone Number : 253-982-3685
Fax Number : 253-982-9037
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2010
Last Update Date : 08/06/2013

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