| NPI | 1144306747 |
|---|---|
| Former Name | ROBERTA J GLENN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 5005) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH E0008241) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2011-11-20 |