Provider Demographics
NPI:1932641479
Name:LARREA-STUART, GLORIA CHRISTINE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:CHRISTINE
Last Name:LARREA-STUART
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 1:6520 BAYCREST CIR
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-3532
Mailing Address - Country:US
Mailing Address - Phone:214-733-0643
Mailing Address - Fax:
Practice Address - Street 1:3200 SOUTHERN DR
Practice Address - Street 2:S 100
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1549
Practice Address - Country:US
Practice Address - Phone:972-271-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12346101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional