Provider Demographics
NPI:1295424786
Name:TORRES, GLORIA DOMINGA
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:DOMINGA
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 CETRONIA RD APT T5
Mailing Address - Street 2:
Mailing Address - City:BREINIGSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18031-1773
Mailing Address - Country:US
Mailing Address - Phone:157-051-7971
Mailing Address - Fax:
Practice Address - Street 1:3975 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-9467
Practice Address - Country:US
Practice Address - Phone:866-666-7610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker