Provider Demographics
NPI:1104683960
Name:SCARUZZI, GLORIA (MSW)
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:SCARUZZI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 KILDARE ST
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33954-3217
Mailing Address - Country:US
Mailing Address - Phone:856-305-7722
Mailing Address - Fax:
Practice Address - Street 1:150 KILDARE ST
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33954-3217
Practice Address - Country:US
Practice Address - Phone:856-305-7722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor