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General NPI Number Information
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NPI Number | 1487688875
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Entity Type | Individual
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Provider Name | MARCELL D GLYNN LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2620 FOUNTAIN VIEW DR SUITE 485
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City | HOUSTON
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State | TX
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Zip | 77057-7621
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Country | US
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Telephone | 713-244-0086
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Fax | 713-244-0059
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Provider Business Mailing Address
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Address Line | 2239 HIGHLAND HILLS DR
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City | SUGAR LAND
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State | TX
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Zip | 77478-4311
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Country | US
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Telephone | 832-858-1947
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Fax | 281-980-8734
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 09042
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License Number State | TX
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