Individual
DR. GLENN E. KNOWLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1401 13TH AVE E, WEST FARGO, ND 58078-3468
(701) 364-0060
(701) 364-0065
Mailing address
1401 13TH AVE E, WEST FARGO, ND 58078-3468
(701) 364-0060
(701) 364-0065
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
210
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16921
—
ND
01
—
21784
BLUECROSS/SHIELD -NO DAK
ND
01
—
266S4KN
BLUE CROSS/SHIELD-MINNESO
MN
01
—
475441026976
PREFERRED ONE
—
01
—
61-77289
MEDICA (UBH)
—
05
—
660352100
—
MN
01
—
HP22979
HEALTHPARTNERS
—
Enumeration date
01/23/2006
Last updated
01/29/2008
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