Provider Demographics
NPI:1982851309
Name:GAGLIARDI, BARBARA PERNICE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:PERNICE
Last Name:GAGLIARDI
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 S MAIN ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-4615
Mailing Address - Country:US
Mailing Address - Phone:928-649-1807
Mailing Address - Fax:
Practice Address - Street 1:703 S MAIN ST
Practice Address - Street 2:SUITE 8
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4615
Practice Address - Country:US
Practice Address - Phone:928-649-1807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-114691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical