Individual
MRS. GLORIA JEAN BANNASCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2323 W EVERETT ST, APPLETON, WI 54914-4749
(920) 217-7861
(920) 560-6618
Mailing address
2323 W EVERETT ST, APPLETON, WI 54914-4749
(920) 217-7861
(920) 560-6618
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4281-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00613383
—
WI
Enumeration date
03/06/2010
Last updated
01/07/2025
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