Provider Demographics
NPI:1851392203
Name:TEMPLETON, GLORIA JEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:JEAN
Last Name:TEMPLETON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:GLORIA
Other - Middle Name:JEAN
Other - Last Name:TEMPLETON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510
Mailing Address - Country:US
Mailing Address - Phone:919-929-9663
Mailing Address - Fax:919-929-9663
Practice Address - Street 1:104 JONES FERRY RD
Practice Address - Street 2:STE. J
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510
Practice Address - Country:US
Practice Address - Phone:919-929-9663
Practice Address - Fax:919-929-9663
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC 1369103T00000X
NC1369103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC03769OtherBCBS
NC130799OtherVALUE OPS
NC03769OtherBCBS