Glenda Gilmer Ezell, LPC
Counselor, Mental Health in Madison, MS. Individual provider (NPI-1).
NPI number1265098545
StatusActive
Last updated in NPPESMay 7, 2023
Details
- NPI
- 1265098545
- Entity type
- Individual (NPI-1)
- Name
- Glenda Gilmer Ezell
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 13, 2019
- Certification date
- Apr 6, 2023
- Last updated
- May 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 2945 | MS | Yes |
Other names
- Glenda D Gilmer (Former Name)
Practice location
505 Cobblestone Ct Ste AMadison, MS 39110-7570
Phone 601-707-5045
Mailing address
505 Cobblestone Ct Ste AMadison, MS 39110-7570
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