Healthcare Provider Details

I. General information

NPI: 1477372431
Provider Name (Legal Business Name): GLOW COACHING AND CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15300 VENTURA BLVD
SHERMAN OAKS CA
91403-3103
US

IV. Provider business mailing address

2108 N ST # 10354
SACRAMENTO CA
95816-5712
US

V. Phone/Fax

Practice location:
  • Phone: 818-856-0022
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JULIA HARTMAN
Title or Position: CEO
Credential:
Phone: 818-856-0022