Individual provider · Type 1 NPI
Tara Lynn Glenn
Specialist · Manorville, NY
NPI number
1245591072
Active
Practice location
34 Winding Path, Apartment 4
Manorville, NY 11949-2279
Mailing address
34 Winding Path Apt 4
Manorville, NY 11949-2280
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | 502823111 (NY) |
| Specialist | 174400000X | 502824111 (NY) |
| Specialist | 174400000X | 423343101 (NY) |
| Specialist | 174400000X | 423342101 (NY) |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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About NPI 1245591072
Tara Lynn Glenn's National Provider Identifier is 1245591072, issued on Jun 7, 2012. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Manorville, NY. The record was last updated on Jun 7, 2012.