Glen Conner, LCSW
Social Worker, Clinical in Stockton, CA. Individual provider (NPI-1).
NPI number1124148481
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1124148481
- Entity type
- Individual (NPI-1)
- Name
- Mr. Glen Conner
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 30, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | LCS 12223 | CA | Yes |
Practice location
1212 N California StStockton, CA 95202-1552
Phone 209-468-3770
Mailing address
2321 Rockingham CirLodi, CA 95242-4554
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