Doctor Name: | MRS. KRISTIN GAGLIARDUCCI |
NPI Number: | 1013378660 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSW |
License Number: | S.1502598 |
Business Practice Address: | 824 Bowtown Rd Delaware, OH - 430159661 |
Business Phone Number: | 7403697688 |
Business Fax Number: | 7403634814 |
Mailing Address: | 824 Bowtown Rd, DELAWARE |
State: | OH |
Postal Code: | 430159661 |
Phone Number: | 7403697688 |
Fax Number: | 7403634814 |
NPI Enumeration Date: | 03/10/2016 |
NPI Last Update Date: | 03/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | S.1502598 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |