Individual
GLENN S. DAVIDSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D., HSPP
Contact information
Practice address
1901 W ROYALE DR, MUNCIE, IN 47304-2265
(765) 282-4317
(765) 282-4362
Mailing address
1901 W ROYALE DR, MUNCIE, IN 47304-2265
(765) 282-4317
(765) 282-4362
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20010351A
IN
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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