Provider Demographics
NPI:1437478559
Name:COBB, GLYNN A (BA)
Entity Type:Individual
Prefix:MISS
First Name:GLYNN
Middle Name:A
Last Name:COBB
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MRS
Other - First Name:GLYNN
Other - Middle Name:A
Other - Last Name:WERTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA
Mailing Address - Street 1:PO BOX 2438
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73648-2438
Mailing Address - Country:US
Mailing Address - Phone:580-225-4337
Mailing Address - Fax:
Practice Address - Street 1:1021 E HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-1906
Practice Address - Country:US
Practice Address - Phone:580-225-4337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor