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NPI Code Detail

MEDICARE: MS. MARTHA ANN GLINTON CACLL

MEDICARE: MS. MARTHA ANN GLINTON CACLL
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1578801452
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARTHA ANN GLINTON CACLL
Provider Business Mailing Address
First Line : PO BOX 1627
Second Line :
City : LANCASTER
State : SC
Zip : 29721-1627
Country : US
Telephone Number : 803-285-6911
Fax Number : 803-286-6697
Provider Business Practice Location Address
First Line : 114 S MAIN ST
Second Line :
City : LANCASTER
State : SC
Zip : 29720-2442
Country : US
Telephone Number : 803-285-6911
Fax Number : 803-286-6697
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2013
Last Update Date : 01/28/2013

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Directions to “ MS. MARTHA ANN GLINTON CACLL” Practice Location

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