Provider Demographics
NPI:1891941639
Name:CLARKSON, GLENDA SUE (MS, LPC,RPT)
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:SUE
Last Name:CLARKSON
Suffix:
Gender:F
Credentials:MS, LPC,RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 LAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-4479
Mailing Address - Country:US
Mailing Address - Phone:903-785-0400
Mailing Address - Fax:
Practice Address - Street 1:737 LAMAR AVE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-4479
Practice Address - Country:US
Practice Address - Phone:903-785-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional