Individual
DEBRA LYNN GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
108 WAIN DR, LONGVIEW, TX 75604-1231
(903) 321-8747
(903) 236-8510
Mailing address
260 SUGAR CREEK LN, LONGVIEW, TX 75605-6750
(307) 421-4557
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
106705
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000071068
BLUE CROSS-SHIELD OF MONTANA
MT
Enumeration date
10/13/2011
Last updated
09/21/2022
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