Provider Demographics
NPI:1417203076
Name:GLENN, CARA ESTHER (RD)
Entity Type:Individual
Prefix:MRS
First Name:CARA
Middle Name:ESTHER
Last Name:GLENN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MISS
Other - First Name:CARA
Other - Middle Name:ESTHER
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:9450 E BECKER LN
Mailing Address - Street 2:UNIT 1023
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:750 E THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-5306
Practice Address - Country:US
Practice Address - Phone:602-866-1220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered