Provider Demographics
NPI:1467112938
Name:GYABAAH, GLADYS ANNOR (PHD)
Entity Type:Individual
Prefix:PROF
First Name:GLADYS
Middle Name:ANNOR
Last Name:GYABAAH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 N HARLEM AVE APT 303
Mailing Address - Street 2:
Mailing Address - City:RIVER FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60305-1550
Mailing Address - Country:US
Mailing Address - Phone:630-670-7473
Mailing Address - Fax:
Practice Address - Street 1:1010 N HARLEM AVE APT 303
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1550
Practice Address - Country:US
Practice Address - Phone:630-670-7473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-27
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 103TA0700X, 103TB0200X, 103TC2200X, 103TF0200X, 103TH0004X, 103TH0100X, 103TM1800X, 1041C0700X, 171M00000X, 183700000X, 103T00000X
IL103TF0200X
IL049165405183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No183700000XPharmacy Service ProvidersPharmacy Technician