Individual
GLENN ROBERT MERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
2557 LINCOLN AVE, OGDEN, UT 84401-1307
(801) 622-5272
Mailing address
2557 LINCOLN AVE, OGDEN, UT 84401-1307
(801) 622-5272
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10636127-3502
UT
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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