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General NPI Number Information
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NPI Number | 1811504558
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Entity Type | Individual
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Provider Name | AUBURN GLITZ
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Gender | Female
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Dates
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Enumeration Date | 09/27/2020
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Last Update Date | 12/06/2022
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Provider Practice Location Address
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Address Line | 13101 ALLEN RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-2216
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Country | US
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Telephone | 734-785-7701
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Fax |
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Provider Business Mailing Address
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Address Line | 9889 WHEELER ST
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City | VAN BUREN TWP
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State | MI
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Zip | 48111-1409
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Country | US
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Telephone | 313-704-4710
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State | MI
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