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General NPI Number Information
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NPI Number | 1457717993
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Entity Type | Organization
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Legal Business Name | MEREDITH GLICK BRINEGAR, PHD, LLC
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Dates
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Enumeration Date | 01/13/2016
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Last Update Date | 01/13/2016
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Provider Practice Location Address
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Address Line | 7071 CORPORATE WAY SUITE 110
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City | DAYTON
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State | OH
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Zip | 45459-8911
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Country | US
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Telephone | 937-259-8594
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Fax |
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Provider Business Mailing Address
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Address Line | 7071 CORPORATE WAY SUITE 110
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City | DAYTON
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State | OH
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Zip | 45459-8911
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. MEREDITH GLICK BRINEGAR
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Credential | PHD
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Telephone | 937-259-8594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6749
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License Number State | OH
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