Provider Demographics
NPI:1790012813
Name:COFFEY, GLORIA ANNE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:ANNE
Last Name:COFFEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 PATTERSON DR
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5645
Mailing Address - Country:US
Mailing Address - Phone:361-575-5021
Mailing Address - Fax:361-575-0623
Practice Address - Street 1:2003 PATTERSON DR
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5645
Practice Address - Country:US
Practice Address - Phone:361-575-5021
Practice Address - Fax:361-575-0623
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18925101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional