Provider Demographics
NPI:1477600617
Name:GLOOR-LITTLE, LITA J (MFT)
Entity Type:Individual
Prefix:MS
First Name:LITA
Middle Name:J
Last Name:GLOOR-LITTLE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-2435
Mailing Address - Country:US
Mailing Address - Phone:925-827-1212
Mailing Address - Fax:925-827-1122
Practice Address - Street 1:415 WARREN ST
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-2435
Practice Address - Country:US
Practice Address - Phone:925-265-6672
Practice Address - Fax:925-827-1122
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 22913106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist