Provider Demographics
NPI:1891714853
Name:HOUSEL, GLENDA JOY (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENDA
Middle Name:JOY
Last Name:HOUSEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 BALTIMORE BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-7144
Mailing Address - Country:US
Mailing Address - Phone:410-833-5452
Mailing Address - Fax:
Practice Address - Street 1:1812 BALTIMORE BLVD
Practice Address - Street 2:STE A
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-7144
Practice Address - Country:US
Practice Address - Phone:410-751-6176
Practice Address - Fax:410-857-4176
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00466902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDM40076OtherCDS REGISTRATION MARYLAND
MDBH0458390OtherFEDERAL CDS CERTIFICATE