Williams, Glenn

Williams, Glenn is an individual health care provider with primary practice located at 12 Southern Ave , Boston MA 02124-2012. He recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as his primary health care specialty. Williams, Glenn can be contacted via phone (617) 291-9667.

Contact Information

Primary practice address
12 Southern Ave Boston MA 02124-2012
Phone: (617) 291-9667
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1295307650
LBN Legal business name Williams, Glenn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2021
Last updated Jul 14th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295307650 NPPES
Massachusetts Other 1174975452 MENTAL HEALTH INSTITUTE

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