Provider Demographics
NPI:1184694002
Name:STELNICKI, GLENNDA SUE (PHD)
Entity type:Individual
Prefix:DR
First Name:GLENNDA
Middle Name:SUE
Last Name:STELNICKI
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 1:500 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840
Practice Address - Country:US
Practice Address - Phone:419-423-3292
Practice Address - Fax:419-423-7662
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5714103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2252655Medicaid
OH2502045Medicaid
OH2502045Medicaid
OH2252655Medicaid