MEDICARE: MRS. GLYN D GIRARD LCSW

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
1	1041C0700X	Clinical Social Worker	086780	NY

General Provider Information

NPI Number	:	1770923377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GLYN D GIRARD LCSW

Provider Business Mailing Address
First Line	:	15840 JEWEL AVE APT TJ
Second Line	:
City	:	FRESH MEADOWS
State	:	NY
Zip	:	11365-3037
Country	:	US
Telephone Number	:	718-337-6800
Fax Number	:

Provider Business Practice Location Address
First Line	:	11021 73RD RD APT 1J
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-6369
Country	:	US
Telephone Number	:	929-398-6232
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2013
Last Update Date	:	10/19/2018

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