Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY4068 | FL |
Y | 103TC0700X | Clinical Psychologist | PY4068 | FL |
N | 103TR0400X | Rehabilitation Psychologist | PY4068 | FL |
NPI | 1689690307 |
---|---|
Provider Name | Glenn Curtiss |
First Address | Land O Lakes, FL 34639-4849 |
Second Address | Tampa, FL 33612-4745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 12/07/2007 |