Individual
MS. MARY K GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SAC
Contact information
Practice address
8809 JOHN C. LODGE SERVICE DRIVE, BUILDING #5, DETROIT, MI 48202
(313) 887-6721
Mailing address
3279 PINGREE ST, DETROIT, MI 48206-2103
(313) 895-1836
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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