Provider Demographics
NPI:1689358046
Name:SCHOLL, GLORIA (MA,)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:SCHOLL
Suffix:
Gender:F
Credentials:MA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 CENTURY WAY E
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2863
Mailing Address - Country:US
Mailing Address - Phone:515-669-8038
Mailing Address - Fax:
Practice Address - Street 1:5920 CENTURY WAY E
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2863
Practice Address - Country:US
Practice Address - Phone:515-669-8038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00122106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist