Individual
DELMAR GLEN PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
810 BRIARWOOD CT, ORANGE CITY, FL 32763
(386) 956-1689
Mailing address
810 BRIARWOOD CT, ORANGE CITY, FL 32763
(386) 774-6366
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY6914
FL
Other
Enumeration date
12/15/2006
Last updated
08/31/2016
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