Healthcare Provider Details

I. General information

NPI: 1891714853
Provider Name (Legal Business Name): GLENDA JOY HOUSEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 08/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 BALTIMORE BLVD STE A
WESTMINSTER MD
21157-7144
US

IV. Provider business mailing address

1812 BALTIMORE BLVD STE A
WESTMINSTER MD
21157-7144
US

V. Phone/Fax

Practice location:
  • Phone: 410-751-6176
  • Fax: 410-857-4176
Mailing address:
  • Phone: 410-833-5452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0046690
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: