Provider Demographics
NPI:1245444793
Name:DURAN, GLORIA (PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:
Last Name:DURAN
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 URB VISTA DEL MAR
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682-6271
Mailing Address - Country:US
Mailing Address - Phone:787-823-5500
Mailing Address - Fax:787-823-2990
Practice Address - Street 1:28 CALLE MUNOZ RIVERA W
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:PR
Practice Address - Zip Code:00677-2127
Practice Address - Country:US
Practice Address - Phone:787-823-5500
Practice Address - Fax:787-823-2990
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1882174400000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No174400000XOther Service ProvidersSpecialist