Individual
COLLEEN GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
614 E ADAMS ST, JACKSON, MO 63755-2150
(573) 243-9501
Mailing address
399 MARK AVE, JACKSON, MO 63755-8527
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2012028152
MO
Other
Enumeration date
09/03/2021
Last updated
09/09/2021
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