Glenn, Mary Leonora

Glenn, Mary Leonora is an sole proprietor health care provider with primary practice located at 256 Concord Ave , Cambridge MA 02138-1337. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Adult Development & Aging is her primary health care specialty. Glenn, Mary Leonora can be contacted via phone (617) 864-4220.

Contact Information

Primary practice address
256 Concord Ave Cambridge MA 02138-1337
Phone: (617) 864-4220
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X 6462 Massachusetts
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6462 Massachusetts
Behavioral Health & Social Service Providers / Family 103TF0000X 6462 Massachusetts
Behavioral Health & Social Service Providers / Psychologist 103T00000X 6462 Massachusetts

Profile Details

NPI number 1164558318
LBN Legal business name Glenn, Mary Leonora
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 24th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164558318 NPPES
Massachusetts Other WO5206 BLUECROSSBLUESHIELD

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