Glenn Wixson, Joel Nathan

Glenn Wixson, Joel Nathan is an individual health care provider with primary practice located at 539 Islington St 5, Portsmouth NH 03801. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Glenn Wixson, Joel Nathan can be contacted via phone (603) 427-6858.

Contact Information

Primary practice address
539 Islington St 5 Portsmouth NH 03801
Phone: (603) 427-6858
Fax: (603) 427-6555
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1056 New Hampshire

Profile Details

NPI number 1174696413
LBN Legal business name Glenn Wixson, Joel Nathan
Credentials PSYD CAS
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2006
Last updated Jul 8th, 2007 - about 17 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 1174696413 NPPES
New Hampshire Other 06Y00744INH01 ANTHEM BCBS
New Hampshire MEDICAID 304ZO374 ANTHEM BCBS

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