Healthcare Provider Details

I. General information

NPI: 1255278420
Provider Name (Legal Business Name): HANNAH MEGAN GLENN PHD, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 45064
MADISON WI
53744-5064
US

IV. Provider business mailing address

PO BOX 45064
MADISON WI
53744-5064
US

V. Phone/Fax

Practice location:
  • Phone: 317-910-8480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number533657
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: