Provider Demographics
NPI:1639443872
Name:GLUTTING, JOAN HASTINGS (PHD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:HASTINGS
Last Name:GLUTTING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PALMER DRIVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824
Mailing Address - Country:US
Mailing Address - Phone:978-328-8372
Mailing Address - Fax:
Practice Address - Street 1:8 PALMER DRIVE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NH
Practice Address - Zip Code:03824
Practice Address - Country:US
Practice Address - Phone:978-328-8372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1118103TC0700X
MA7418103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical