Gloria Leyla Fanning Tacoaman
Gloria Leyla Fanning Tacoaman is a Mental Health Counselor in Wilmington, Massachusetts. Licensed in Massachusetts. Registered with an NPI since 2020.
- Licensed in
- MA
- In the registry since
- 2020
- Specialties on file
- 2
Practice location Address checks out
60 Concord St Ste 1Wilmington, MA 01887-2179
Phone: (781) 694-8787
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Specialties & licences
| Behavior Analyst (primary) | Taxonomy 103K00000X · Licence LABA10000079 (MA) |
|---|---|
| Mental Health Counselor | Taxonomy 101YM0800X |
Record details
| NPI number | 1053921114 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | August 4, 2020 |
| Last updated in NPPES | May 9, 2023 |
| Certification date | May 9, 2023 |
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Julie A Fiore
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