Provider Demographics
NPI:1952191215
Name:GLYMPH, DANITA C
Entity type:Individual
Prefix:
First Name:DANITA
Middle Name:C
Last Name:GLYMPH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:DANITA
Other - Middle Name:C
Other - Last Name:GLYMPH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:50 LENOX POINTE NE STE A
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3103
Mailing Address - Country:US
Mailing Address - Phone:678-824-6590
Mailing Address - Fax:678-228-1258
Practice Address - Street 1:50 LENOX POINTE NE STE A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3103
Practice Address - Country:US
Practice Address - Phone:678-824-6590
Practice Address - Fax:678-228-1258
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health