Provider Demographics
NPI:1356788509
Name:PSYCHOLOGICAL SERVICES OF GLYNDA THUME PHD, INC
Entity type:Organization
Organization Name:PSYCHOLOGICAL SERVICES OF GLYNDA THUME PHD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GLYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:THUME
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:818-712-9886
Mailing Address - Street 1:23123 VENTURA BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1104
Mailing Address - Country:US
Mailing Address - Phone:818-712-9886
Mailing Address - Fax:
Practice Address - Street 1:23123 VENTURA BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1104
Practice Address - Country:US
Practice Address - Phone:818-712-9886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14893103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty