NPI | 1255638904 |
---|---|
Former Name | DENISE M GLASSMOYER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AZ 4169) |
Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: AZ 4169) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 4169) | |
Enumeration Date | 2011-02-16 |
Last Update Date | 2022-07-21 |