Provider Demographics
NPI:1346413549
Name:GLATT, PATRICIA FLEENER (MSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:FLEENER
Last Name:GLATT
Suffix:
Gender:F
Credentials:MSW
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 298
Mailing Address - Street 2:
Mailing Address - City:KITTRELL
Mailing Address - State:NC
Mailing Address - Zip Code:27544-0298
Mailing Address - Country:US
Mailing Address - Phone:252-433-0300
Mailing Address - Fax:252-433-8054
Practice Address - Street 1:109 N GARNETT ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-4637
Practice Address - Country:US
Practice Address - Phone:252-433-0300
Practice Address - Fax:252-433-8054
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0054551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical