Basic Information
| Provider Information | |||||||||
| NPI: | 1912204686 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEUNIER | ||||||||
| FirstName: | GLENN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 362 N BEDFORD ST | ||||||||
| Address2: | |||||||||
| City: | EAST BRIDGEWATER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023331148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083502450 | ||||||||
| FaxNumber: | 5083502319 | ||||||||
| Practice Location | |||||||||
| Address1: | 430 PLYMOUTH ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | HALIFAX | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023381342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7814222900 | ||||||||
| FaxNumber: | 7814222905 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2011 | ||||||||
| LastUpdateDate: | 03/10/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 115926 | MA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.