Organization
GLYNN ROUX SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY DEE GLYNN ROUX (MANAGER)
(617) 875-5719
Entity
Organization
Contact information
Practice address
450 N MAIN ST, SHARON, MA 02067-1172
(617) 875-5719
Mailing address
PO BOX 93, SHARON, MA 02067-0093
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
9942
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851600985
TYPE 1 NPI NUMBER (USED PRIOR TO FORMING LLC AND REQUESTING TYPE 2 NPI)
MA
Enumeration date
07/14/2015
Last updated
07/14/2015
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