Individual
MR. DENNIS R. GLAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
714 CALLE DON DIEGO, ESPANOLA, NM 87532-3414
(505) 367-3342
Mailing address
1507 MONTANA VISTA ST, ESPANOLA, NM 87532-3275
(505) 753-5442
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-0895
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
97282
—
NM
Enumeration date
03/28/2007
Last updated
07/09/2007
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