| Doctor Name: | GLENROY PATRICK PATTERSON |
| NPI Number: | 1063754653 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | BCBA |
| License Number: | |
| Business Practice Address: | 14 Pacella Park Dr Randolph, MA - 023681756 |
| Business Phone Number: | 7814400400 |
| Business Fax Number: | 7814371220 |
| Mailing Address: | 72 Birchwood Rd, EAST HARTFORD |
| State: | CT |
| Postal Code: | 061181702 |
| Phone Number: | 8603834423 |
| Fax Number: | 8603834423 |
| NPI Enumeration Date: | 03/21/2013 |
| NPI Last Update Date: | 03/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |