Individual
DR. GLENN A FELTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
430 S MAIN ST, URBANA, OH 43078-2402
(937) 652-1474
Mailing address
430 S MAIN ST, URBANA, OH 43078-2402
(937) 652-1474
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3924
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000002319
BLUE CROSS BLUE SHIELD
OH
05
—
0686306
—
OH
Enumeration date
01/02/2007
Last updated
07/08/2007
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