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Organization

GLOW SERVICES, LLC

Active
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Organization

GLOW SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICKELL DANIELS (CEO/LEAD THERAPIST)
(414) 628-0112
Entity
Organization

Contact information

Practice address
2300 W HOPKINS ST, MILWAUKEE, WI 53206-1749
(414) 218-1001
Mailing address
PO BOX 91352, MILWAUKEE, WI 53209-8352
(414) 628-0112

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
106H00000X
Marriage & Family Therapist

Other

Enumeration date
06/08/2023
Last updated
06/08/2023
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