Individual
GLORIA MARIA GUILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
4600 3RD ST, MOLINE, IL 61265-6106
(309) 779-2031
Mailing address
1710 RIDGEWOOD AVE, DAVENPORT, IA 52803-3453
(956) 367-0496
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.020480
IA
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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