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General NPI Number Information
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NPI Number | 1881809762
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Entity Type | Individual
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Provider Name | DANIEL JOHN GLYNN JR. PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 05/13/2007
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Last Update Date | 03/11/2015
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Provider Practice Location Address
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Address Line | 1750 S ERIE HWY
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City | HAMILTON
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State | OH
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Zip | 45011-4118
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Country | US
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Telephone | 513-477-9216
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Fax |
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Provider Business Mailing Address
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Address Line | 1750 S ERIE HWY
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City | HAMILTON
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State | OH
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Zip | 45011-4118
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Country | US
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Telephone | 513-477-9216
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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 | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | 20042217A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 5607
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License Number State | OH
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