Provider Demographics
NPI:1457428237
Name:GLENN, EMILY D (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:D
Last Name:GLENN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12261 BURGESS LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-6979
Mailing Address - Country:US
Mailing Address - Phone:817-933-8939
Mailing Address - Fax:
Practice Address - Street 1:6942 ASH ST
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5025
Practice Address - Country:US
Practice Address - Phone:817-933-8939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63216101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor