Basic Information
| Provider Information | |||||||||
| NPI: | 1477975761 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GLEN | ||||||||
| FirstName: | JOY | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | M.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3373 PRINCETON RD | ||||||||
| Address2: | SUITE #D117 | ||||||||
| City: | HAMILTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450115416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138954327 | ||||||||
| FaxNumber: | 5138944327 | ||||||||
| Practice Location | |||||||||
| Address1: | 3373 PRINCETON RD | ||||||||
| Address2: | SUITE D117 | ||||||||
| City: | HAMILTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450115416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138954327 | ||||||||
| FaxNumber: | 5138944327 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/06/2014 | ||||||||
| LastUpdateDate: | 11/09/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | A. 01880 | OH | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.