Individual
MRS. GLINDA JOHNSON MEDLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6079 MAIN ST, EAST PETERSBURG, PA 17520-1267
(717) 560-1908
Mailing address
200 N 7TH ST, LEBANON, PA 17046-5040
(717) 272-5464
(717) 376-1712
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
SW006656L
PA
1041C0700X
Clinical Social Worker
Primary
CW019286
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019289090003
—
PA
Enumeration date
04/18/2007
Last updated
10/07/2020
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