Provider Demographics
NPI:1467484840
Name:CANTU, GLORIA (EDD, LPC)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:CANTU
Suffix:
Gender:F
Credentials:EDD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 FANNIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-3258
Mailing Address - Country:US
Mailing Address - Phone:713-652-0011
Mailing Address - Fax:713-652-0015
Practice Address - Street 1:3033 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-3258
Practice Address - Country:US
Practice Address - Phone:713-652-0011
Practice Address - Fax:713-652-0015
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19765101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional