| Doctor Name: | DR. GLEN KERCHER |
| NPI Number: | 1023027224 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 2-1320 |
| Business Practice Address: | 2804 Lake Rd Suite 2 Huntsville, TX - 773405626 |
| Business Phone Number: | 9362916577 |
| Business Fax Number: | 9362910403 |
| Mailing Address: | 2804 Lake Rd, Suite 2 HUNTSVILLE |
| State: | TX |
| Postal Code: | 773405626 |
| Phone Number: | 9362916577 |
| Fax Number: | 9362910403 |
| NPI Enumeration Date: | 08/05/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2-1320 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |