Provider Demographics
NPI:1205144607
Name:CLIFTON, GLORIA
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:CLIFTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 505198
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-5198
Mailing Address - Country:US
Mailing Address - Phone:617-466-1169
Mailing Address - Fax:617-466-1169
Practice Address - Street 1:855 BROADWAY APT 310
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-3033
Practice Address - Country:US
Practice Address - Phone:617-466-1169
Practice Address - Fax:617-466-1169
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor