Provider Demographics
NPI:1811714496
Name:GLYNN, MILENA (MS, MFT)
Entity type:Individual
Prefix:
First Name:MILENA
Middle Name:
Last Name:GLYNN
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WHITMARSH LN
Mailing Address - Street 2:
Mailing Address - City:EAST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02333-1263
Mailing Address - Country:US
Mailing Address - Phone:973-309-0202
Mailing Address - Fax:
Practice Address - Street 1:200 INTERNATIONAL DR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-6833
Practice Address - Country:US
Practice Address - Phone:774-256-2515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist