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NPI Code Detail

MEDICARE: MS. JENNIFER LYNNE GLENN MED, MS, CAGS, NCSP

MEDICARE: MS. JENNIFER LYNNE GLENN MED, MS, CAGS, NCSP
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
1103TS0200XSchool PsychologistLSP01261OH

General Provider Information

NPI Number : 1295667038
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER LYNNE GLENN MED, MS, CAGS, NCSP
Provider Business Mailing Address
First Line : 737 E HUDSON ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43211-1034
Country : US
Telephone Number : 380-997-3265
Fax Number :
Provider Business Practice Location Address
First Line : 737 E HUDSON ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43211-1034
Country : US
Telephone Number : 380-997-3265
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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