Provider Demographics
NPI:1275292385
Name:KEY, GLORIA VICTORIA (LMSW)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:VICTORIA
Last Name:KEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10275 RIDGELINE DR
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20886-3009
Mailing Address - Country:US
Mailing Address - Phone:845-300-1018
Mailing Address - Fax:
Practice Address - Street 1:10275 RIDGELINE DR
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20886-3009
Practice Address - Country:US
Practice Address - Phone:845-300-1018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
27724104100000X
MD27724104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker