Provider Demographics
NPI:1841383320
Name:MARESMA, GLORIA C (LMHC, LMFT)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:C
Last Name:MARESMA
Suffix:
Gender:F
Credentials:LMHC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2813 S HIAWASSEE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-6300
Mailing Address - Country:US
Mailing Address - Phone:407-446-1402
Mailing Address - Fax:407-822-3702
Practice Address - Street 1:2813 S HIAWASSEE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6300
Practice Address - Country:US
Practice Address - Phone:407-446-1402
Practice Address - Fax:407-822-3702
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH3269101YM0800X
COLPC3024101YP2500X
FLMT1700106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional