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General NPI Number Information
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NPI Number | 1972622421
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Entity Type | Organization
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Legal Business Name | GLENN SHORT'S APPLIED ALTERNATIVES, LLC
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 405 N CHERRY ST
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City | ALPINE
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State | TX
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Zip | 79830-3303
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Country | US
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Telephone | 432-294-0732
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Fax | 432-837-2039
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Provider Business Mailing Address
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Address Line | 405 N CHERRY ST
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City | ALPINE
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State | TX
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Zip | 79830-3303
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Country | US
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Telephone | 432-294-0732
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Fax | 432-837-2039
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Authorized Official
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Title or Position | OWNER, COUNSELOR
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Name | MR. GLENN DAVID SHORT
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Credential | LPC
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Telephone | 432-294-0732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 20028
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License Number State | TX
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