Individual
DR. GLENN CHARLES CLOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
4554 E INVERNESS AVE, SUITE C-11, MESA, AZ 85206-4639
(480) 226-0917
Mailing address
4554 E INVERNESS AVE, SUITE C-11, MESA, AZ 85206-4639
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3583
AZ
Other
Enumeration date
05/11/2007
Last updated
07/08/2007
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