Individual
MS. GLORIA LORRAINE FAITHEAD I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
SUFFOLK COUNTY DEPARTMENT OF HEALTH, DAY REPORTING CENTER N COUNTY COMPLEX BLDG#16, HAUPPAUGE, NY 11788
(631) 853-6277
(631) 853-6254
Mailing address
334 LAKELAND AVE, APT 4G, SAYVILLE, NY 11782-1930
(631) 750-5086
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11889
NY
Other
Enumeration date
05/27/2008
Last updated
05/27/2008
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