Provider Demographics
NPI:1750428777
Name:BARANY, GLORIA JEAN (LMT NCTMB)
Entity type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:JEAN
Last Name:BARANY
Suffix:
Gender:F
Credentials:LMT NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52303 EMMONS RD STE 25
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46637-4288
Mailing Address - Country:US
Mailing Address - Phone:574-277-2323
Mailing Address - Fax:574-277-2323
Practice Address - Street 1:52303 EMMONS RD STE 25
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46637-4288
Practice Address - Country:US
Practice Address - Phone:574-277-2323
Practice Address - Fax:574-277-2323
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA31544225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist