Dr. Gloria Marie Roque, Ph.D.
Psychologist, Clinical in Birmingham, AL. Individual provider (NPI-1).
NPI number1972519973
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1972519973
- Entity type
- Individual (NPI-1)
- Name
- Dr. Gloria Marie Roque
- Credential
- Ph.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 31, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Part B No · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 690 | AL | Yes |
Practice location
700 19th St SBirmingham, AL 35233-1927
Phone 205-933-8101 · Fax 205-212-3915
Mailing address
700 19th St SBirmingham, AL 35233-1927
Phone 205-933-8101 · Fax 205-212-3915
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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