Individual
GLEN LEVINZON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5558 S 1900 W, TAYLORSVILLE, UT 84129-9007
(801) 255-5131
Mailing address
6013 S REDWOOD RD, TAYLORSVILLE, UT 84123-5220
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104119619
MENTAL HEALTH INTERN
—
Enumeration date
08/30/2022
Last updated
08/30/2022
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