Provider Demographics
NPI:1659735603
Name:WASHINGTON, GLORIA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 JUDITH ST
Mailing Address - Street 2:
Mailing Address - City:WESTWEGO
Mailing Address - State:LA
Mailing Address - Zip Code:70094-2176
Mailing Address - Country:US
Mailing Address - Phone:504-431-0124
Mailing Address - Fax:
Practice Address - Street 1:8470 MORRISON RD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-1913
Practice Address - Country:US
Practice Address - Phone:504-248-1581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9747104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker