Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | S.2005223 | OH |
NPI | 1003192006 |
---|---|
Provider Name | Ms. Cara M Glaze |
First Address | Howard, OH 43028-8020 |
Second Address | Mount Vernon, OH 43050-4476 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2011 |
Last Update Date | 10/02/2021 |