| Doctor Name: | GLENDA L GEORGENS |
| NPI Number: | 1215159561 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MHC, NCC |
| License Number: | 113 |
| Business Practice Address: | 125 W Kamehameha Ave Kahului, HI - 967322237 |
| Business Phone Number: | 8088770586 |
| Business Fax Number: | |
| Mailing Address: | 83 Ikena Kai Place, KULA |
| State: | HI |
| Postal Code: | 96790 |
| Phone Number: | 8082143561 |
| Fax Number: | 8087873490 |
| NPI Enumeration Date: | 05/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 113 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |