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NPI Code Detail

MEDICARE: CAROLINE ELIZABETH GLENN

MEDICARE: CAROLINE ELIZABETH GLENN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TR0400XRehabilitation Psychologist

General Provider Information

NPI Number : 1013600865
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINE ELIZABETH GLENN
Provider Business Mailing Address
First Line : 6906 SUMMIT LAKE DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-3320
Country : US
Telephone Number : 513-378-1373
Fax Number :
Provider Business Practice Location Address
First Line : 5505 CHEVIOT RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-7003
Country : US
Telephone Number : 513-740-1001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2023
Last Update Date : 05/30/2023

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Directions to “ CAROLINE ELIZABETH GLENN ” Practice Location

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