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General NPI Number Information
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NPI Number | 1770923377
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Entity Type | Individual
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Provider Name | GLYN D GIRARD LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/27/2013
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Last Update Date | 10/19/2018
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Provider Practice Location Address
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Address Line | 11021 73RD RD APT 1J
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City | FOREST HILLS
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State | NY
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Zip | 11375-6369
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Country | US
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Telephone | 929-398-6232
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Fax |
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Provider Business Mailing Address
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Address Line | 15840 JEWEL AVE APT TJ
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City | FRESH MEADOWS
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State | NY
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Zip | 11365-3037
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Country | US
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Telephone | 718-337-6800
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 086780
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License Number State | NY
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