Basic Information
| Provider Information | |||||||||
| NPI: | 1477097913 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CUDICIO-HAYDEN | ||||||||
| FirstName: | GLORIA | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | |||||||||
| Credential: | MS, NCC | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | GLORIA | ||||||||
| OtherFirstName: | FITCH | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 225 S ARLINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171092610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708991816 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 960 CENTURY DR | ||||||||
| Address2: | |||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170554530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177950330 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2016 | ||||||||
| LastUpdateDate: | 12/16/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.