Individual
DR. GLENN I SWIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3425 EXECUTIVE PKWY, SUITE 230, TOLEDO, OH 43606-1326
(419) 531-3500
(419) 531-1877
Mailing address
PO BOX 74872, CLEVELAND, OH 44194-0002
(419) 531-3500
(419) 531-1877
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3680
OH
103TC0700X
Clinical Psychologist
6301007588
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000139785
ANTHEM PROVIDER
OH
01
—
00412
PARAMOUNT PROV
OH
05
—
0911811
—
OH
Enumeration date
01/04/2007
Last updated
11/02/2011
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