Provider Demographics
NPI:1578597167
Name:WAUGH, GLORIA S (MA, LPC)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:S
Last Name:WAUGH
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6030 BAY RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-8703
Mailing Address - Country:US
Mailing Address - Phone:989-244-1888
Mailing Address - Fax:989-321-6544
Practice Address - Street 1:6030 BAY RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604
Practice Address - Country:US
Practice Address - Phone:989-244-1888
Practice Address - Fax:989-321-6544
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009013101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health