NPI | 1609376706 |
---|---|
Former Name | BRIAN MCGLENN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0022074) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR P2408009) |
Enumeration Date | 2018-02-15 |
Last Update Date | 2025-08-25 |