Provider Demographics
NPI:1831477801
Name:MORALES, GLADYS
Entity Type:Individual
Prefix:MISS
First Name:GLADYS
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 MOUNTAIN RAIL DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-3130
Mailing Address - Country:US
Mailing Address - Phone:702-834-8954
Mailing Address - Fax:
Practice Address - Street 1:4431 S EASTERN AVE
Practice Address - Street 2:STE 1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7850
Practice Address - Country:US
Practice Address - Phone:702-750-0377
Practice Address - Fax:702-538-7928
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health