Provider Demographics
NPI:1043403322
Name:DILBECK, GLYNN DOUGLAS (MA)
Entity Type:Individual
Prefix:MR
First Name:GLYNN
Middle Name:DOUGLAS
Last Name:DILBECK
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9110
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-6924
Mailing Address - Country:US
Mailing Address - Phone:615-943-8145
Mailing Address - Fax:615-230-8145
Practice Address - Street 1:11 MUSIC CIRCLE SOUTH
Practice Address - Street 2:SUITE 106
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-943-8145
Practice Address - Fax:615-230-8145
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPE1725101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional