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NPI Code Detail

MEDICARE: MS. GLORIA JEAN MONROE LCSW

MEDICARE: MS. GLORIA JEAN MONROE LCSW
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
11041C0700XClinical Social Worker668LA

General Provider Information

NPI Number : 1770547184
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GLORIA JEAN MONROE LCSW
Provider Business Mailing Address
First Line : 19 OAKWOOD DR
Second Line :
City : MONROE
State : LA
Zip : 71203-2754
Country : US
Telephone Number : 318-343-4868
Fax Number : 318-388-0948
Provider Business Practice Location Address
First Line : 2913 DESIARD ST
Second Line :
City : MONROE
State : LA
Zip : 71201-7207
Country : US
Telephone Number : 318-388-1250
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2006
Last Update Date : 07/08/2007

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