Individual
MRS. BONITA GUTHRIE GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
245 CAHABA VALLEY PKWY, STE 200, PELHAM, AL 35124-2216
(205) 942-6820
(205) 942-5627
Mailing address
7359 FRANCES DR, MORRIS, AL 35116-2114
(205) 681-5414
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0323
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-11052
BLUE CROSS BLUE SHIELD
AL
Enumeration date
02/13/2007
Last updated
07/08/2007
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