Healthcare Provider Details

I. General information

NPI: 1023501897
Provider Name (Legal Business Name): GLENNA MARIE HUFF CRS, CIRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2018
Last Update Date: 06/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4449 STATE ROUTE 159
CHILLICOTHEE OH
45601-8620
US

IV. Provider business mailing address

4449 SR 159
CHILLICOTHEE OH
45601
US

V. Phone/Fax

Practice location:
  • Phone: 614-440-0690
  • Fax:
Mailing address:
  • Phone: 740-775-1260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: