Doctor Name: | DR. GLENN H HEATH |
NPI Number: | 1568417541 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | PS001094L |
Business Practice Address: | 1509 Markley Rd Pennsburg, PA - 180731923 |
Business Phone Number: | 2155655876 |
Business Fax Number: | |
Mailing Address: | 1509 Markley Rd, PENNSBURG |
State: | PA |
Postal Code: | 180731923 |
Phone Number: | 2156795998 |
Fax Number: | |
NPI Enumeration Date: | 05/24/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PS001094L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |