Individual
ANITA GLENN-RELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
317 LIGHTNING AVE, LUKE AFB, AZ 85309
(623) 856-8754
Mailing address
13327 N 152ND AVE, SURPRISE, AZ 85379-9119
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2817
OR
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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