Provider Demographics
NPI:1053776278
Name:GLADNESS, MEILLANNY (PHD)
Entity type:Individual
Prefix:
First Name:MEILLANNY
Middle Name:
Last Name:GLADNESS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23151 VERDUGO DR STE 203
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1343
Mailing Address - Country:US
Mailing Address - Phone:949-899-5611
Mailing Address - Fax:
Practice Address - Street 1:23151 VERDUGO DR STE 203
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-899-5611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral