Individual
GLENN MAKUPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3636 LAS VEGAS BLVD N STE B, LAS VEGAS, NV 89115-1556
(702) 776-8397
Mailing address
3636 LAS VEGAS BLVD N STE B, LAS VEGAS, NV 89115-1556
(702) 776-8397
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NV
Other
Enumeration date
03/25/2014
Last updated
03/25/2014
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