Individual
MR. GLEN ANDREW CANTER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4700
Mailing address
4332 TRANQUILLA AVE, ATASCADERO, CA 93422-2867
(805) 234-4713
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
32987
CA
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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