Provider Demographics
NPI:1225380561
Name:ADAMS, GLYNIS LAVERN (MSW INTERN)
Entity Type:Individual
Prefix:MS
First Name:GLYNIS
Middle Name:LAVERN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MSW INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 CAMPUS DR APT 206
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4927
Mailing Address - Country:US
Mailing Address - Phone:650-993-8694
Mailing Address - Fax:
Practice Address - Street 1:900 CAMPUS DR APT 206
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-4927
Practice Address - Country:US
Practice Address - Phone:650-993-8694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health