| NPI | 1164631727 |
|---|---|
| Other Name | CHONTAY TAYLOR GLENN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MI 4704208682) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 163WC1500X Registered Nurse Community Health (Licence: MI 4704208682) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2025-09-03 |