Provider Demographics
NPI:1720497472
Name:STOILOVA, GLORIA KRASSIMIROVA (EDS, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:KRASSIMIROVA
Last Name:STOILOVA
Suffix:
Gender:F
Credentials:EDS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 MAPLE TREE CT STE 101
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4079
Mailing Address - Country:US
Mailing Address - Phone:864-271-0975
Mailing Address - Fax:864-241-9001
Practice Address - Street 1:1530 RICHLAND ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201
Practice Address - Country:US
Practice Address - Phone:803-252-4040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-07
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4561106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4561OtherLMFT