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Individual

GLORIA J PELLETIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CISW, LISAC

Contact information

Practice address
219 N SIERRA VISTA DR, TUCSON, AZ 85719-3842
(928) 412-4872
Mailing address
219 N SIERRA VISTA DR, TUCSON, AZ 85719-3842
(928) 412-4872

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-11825
1041C0700X
Clinical Social Worker
Primary
LCSW-3408
AZ

Other

Enumeration date
04/08/2021
Last updated
04/08/2021
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