Provider Demographics
NPI:1033247820
Name:NORDMARK, GLORIA SUE
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:SUE
Last Name:NORDMARK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6627 CREEKMONT WAY
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-1841
Mailing Address - Country:US
Mailing Address - Phone:916-723-5347
Mailing Address - Fax:916-875-0871
Practice Address - Street 1:6627 CREEKMONT WAY
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-1841
Practice Address - Country:US
Practice Address - Phone:916-723-5347
Practice Address - Fax:916-875-0871
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor