| NPI | 1265682744 |
|---|---|
| Former Name | KATIE LYNN GLENN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-34183) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 29090) |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2019-03-28 |