Individual
JEFFREY GLIDDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
112 N BROAD ST, PHILADELPHIA, PA 19102-1512
(215) 568-0860
Mailing address
112 N BROAD ST, PHILADELPHIA, PA 19102-1512
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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