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Individual

SAMANTHA GLENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
505 S WASHBURN ST, OSHKOSH, WI 54904-7949
(920) 232-2332
Mailing address
225 MAIN ST APT 309, MENASHA, WI 54952-2729
(920) 289-0638

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
12/20/2022
Last updated
12/20/2022
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