Individual
DENISE GLANVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
315 W PONCE DE LEON AVE, SUITE 1051, DECATUR, GA 30030-2400
(404) 378-0441
Mailing address
3316 S COBB DR SE STE A, SUITE 324, SMYRNA, GA 30080-4107
(404) 966-7505
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
PSY003074
GA
103TC0700X
Clinical Psychologist
04127
MD
103TC0700X
Clinical Psychologist
Primary
PSY003074
GA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY003074
GA
Other
Enumeration date
12/29/2006
Last updated
10/07/2010
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