Provider Demographics
NPI:1699551465
Name:VEAL, GLENN ASHLEIGH
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:ASHLEIGH
Last Name:VEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GLENN
Other - Middle Name:ASHLEIGH
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:765 NEWMORN DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-2002
Mailing Address - Country:US
Mailing Address - Phone:770-365-0837
Mailing Address - Fax:
Practice Address - Street 1:230 W COLLEGE ST STE D
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4249
Practice Address - Country:US
Practice Address - Phone:678-688-3133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist