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Individual
RODNEY MAURICE GLENN
Active
Individual
RODNEY MAURICE GLENN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.A.
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00007473
—
CA
01
—
CBSC297
LA DMH PROVIDER
CA
Enumeration date
04/09/2007
Last updated
05/20/2013
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