Individual
GLENN SCOTT MIDDLETON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
BLDG D 2004 MARION STREET, USASOC PAD, FORT BRAGG, NC 28310-0001
(910) 907-8922
Mailing address
2817 REILLY RD, MCXC COD CREDENTIALS, FORT BRAGG, NC 28310-7324
(910) 907-8922
(910) 907-6069
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3429
OH
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
AD003542
OH
Other
Enumeration date
12/23/2005
Last updated
09/11/2025
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