Provider Demographics
NPI:1952663130
Name:BARBER, GLORIA (MS)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:
Last Name:BARBER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:GLORIA
Other - Middle Name:
Other - Last Name:BARBER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:1137 MARTINSTEIN AVE
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-2042
Mailing Address - Country:US
Mailing Address - Phone:631-455-9043
Mailing Address - Fax:
Practice Address - Street 1:1137 MARTINSTEIN AVE
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-2042
Practice Address - Country:US
Practice Address - Phone:631-455-9043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health