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1134753387
GLEN EDWARD HAIRSTON
MARTINSVILLE, VA
NPI
1134753387
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
Enumeration Date
2020-02-26
Last Update Date
2020-02-28
Business Address
GLEN EDWARD HAIRSTON
133 E MARKET ST STE 102
MARTINSVILLE, VA 24112-3740
Phone number: 276-806-9177
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Mailing Address
GLEN EDWARD HAIRSTON
PO BOX 3148
MARTINSVILLE, VA 24115-3148
Phone number: 276-806-9177
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