Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PS018910 | PA |
Y | 103TC0700X | Clinical Psychologist | PS018910 | PA |
NPI | 1003457672 |
---|---|
Provider Name | Dr. Megan A Glenn |
First Address | Mount Laurel, NJ 08054-5645 |
Second Address | Philadelphia, PA 19104-4551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2019 |
Last Update Date | 02/02/2021 |