Individual
MR. GLENN GARY GREENE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
5118 PARK AVE, MEMPHIS, TN 38117-5720
(901) 458-8638
Mailing address
5118 PARK AVE, MEMPHIS, TN 38117-5720
(901) 458-8638
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSW0000009089
TN
Other
Enumeration date
11/16/2011
Last updated
11/16/2011
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